가바펜틴
가바펜틴은 감마아미노뷰티르산(GABA)의 구조적 유사체로, 수의학에서 주로 **신경병증성 진통** 및 **항경련** 특성으로 널리 사용됩니다. * **진통 작용**: 만성, 부적응성 및 신경병증성 통증(예: 골관절염, 추간판 질환, 암성 통증)에 매우 효과적입니다. 종종 다중 모드 진통 요법의 일부로 사용됩니다. * **발작 관리**: 난치성 또는 복합 부분 발작을 위한 보조 항경련제(AED)로 사용되지만, 단독 약물로서의 효능은 제한적입니다. * **행동/항불안**: 동물병원 방문이나 스트레스가 많은 사건 전에 두려움, 불안, 스트레스(FAS)를 줄이기 위해 고양이와 개에서 오프라벨로 점점 더 많이 사용되고 있습니다.
작용 기전: Despite its name, gabapentin does *not* bind to GABA receptors, nor does it affect GABA synthesis or uptake. * Binds selectively to the **α2-δ (alpha-2-delta) subunit** of **voltage-gated calcium channels (CaV)** in the central nervous system. * **Inhibition of Calcium Influx** → Decreased presynaptic calcium currents. * **Reduced Neurotransmitter Release** → Suppresses the release of excitatory neurotransmitters including **glutamate**, **substance P**, and **norepinephrine** in the dorsal horn of the spinal cord. * This dampens neuronal excitability, effectively preventing **allodynia** (pain from non-noxious stimuli) and **hyperalgesia** (exaggerated pain response).
동물 종별 용량
- Ancillary therapy of refractory seizures · 5-10 mg/kg · PO · q8-12h
- Ancillary therapy of refractory seizures · 5 mg/kg · PO · three times daily
- Ancillary therapy of refractory seizures · 10-30 mg/kg · PO · q8-12h
- Analgesic · 1.25-10 mg/kg · PO · q24h
- Adjunctive treatment of chronic or cancer pain · 3 mg/kg · PO · once a day
- Adjunctive analgesia associated with neuropathic pain · 2.5-5 mg/kg · PO · q12h · Author starts at 5 mg/kg and increases (up to 10 mg/kg) if no effect seen in two hours. Wean off slowly. Reduce in renal insufficiency.
- Analgesic · 5-10 mg/kg · PO · 2-3 times a day · Most VIN consultants recommend this dose.
- Analgesic · 50 mg (total dose) per cat · PO · 1-3 times a day
- Adjunctive seizure therapy / Chronic pain · 5-10 mg/kg · PO · q8-12h · starting dose; incremental dose increases are recommended
- Ancillary therapy of refractory seizures · 10-20 mg/kg · PO · q6-8h · Author notes gabapentin is the least effective of the newer antiepileptic drugs, particularly in dogs.
- Ancillary therapy of refractory seizures · 10-30 mg/kg · PO · q8-12h
투여 경로
금기
- Hypersensitivity to gabapentin
- Use of xylitol-containing human oral solutions in dogs
- Oral solutions containing xylitol (highly toxic to dogs)
이상반응
- Sedation
- Ataxia
- Dizziness (humans)
- Somnolence
- Peripheral edema (humans)
- Withdrawal-precipitated seizures (if abruptly discontinued)
- Increased rate of pancreatic adenocarcinoma (noted in male rats)
- Mild sedation
- False-positive urinary protein tests (reported in humans)
- Hepatic toxicity (rare, reported in humans)
약물 상호작용
- Antacids · Oral antacids given concurrently may decrease oral bioavailability of gabapentin by 20%; separate doses by at least 2 hours.
- Hydrocodone · Co-administration may increase gabapentin AUC and efficacy/adverse effects. Gabapentin may reduce hydrocodone AUC, potentially reducing its effectiveness.
- Morphine · May increase gabapentin levels.
- Antacids (containing aluminium and magnesium) · Reduced absorption of gabapentin from the GI tract. Administer gabapentin at least 2 hours after antacids. · moderate
- Cimetidine · Reduced renal clearance of gabapentin (not considered clinically important). · minor
모니터링
- Clinical efficacy (reduction in pain scores or seizure frequency)
- Adverse effects (sedation, ataxia)
- Renal function (in patients with pre-existing disease)
- Clinical response (pain scores, seizure frequency)
- Renal and hepatic function in compromised patients
과용량
In humans, massive overdoses (up to 49 grams) have been reported without fatality. * **Clinical Signs**: Ataxia, lethargy, somnolence, vomiting, and diarrhea. * **Xylitol Toxicity Risk**: The human oral solution contains 300 mg/mL of xylitol. Doses as low as 0.33 mL/kg of this solution can cause severe hypoglycemia or hepatotoxicity in dogs. * **Treatment**: Primarily supportive. General decontamination (emesis, activated charcoal, cathartics) if caught early. The drug can be removed via hemodialysis. If xylitol toxicity is suspected secondary to the human liquid formulation, aggressive treatment for hypoglycemia and liver protection is required; contact an animal poison control center.
VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.