젬시타빈

항종양제 - 피리미딘 대사 길항제

젬시타빈(Gemcitabine)은 항종양제로 사용되는 **합성 피리미딘 뉴클레오시드 유사체**입니다. - **수의학적 용도**: 현재 임상 데이터가 제한적이며 시험적 치료로 간주됩니다. 절제 불가능한 종양에 대한 **방사선 민감제**로서 또는 병용 화학요법(예: 카보플라틴과 병용)의 일부로 잠재력을 보여줍니다. - **인체 용도**: 췌장암, 소세포 폐암, 방광암, 연조직 암종 및 림프종 치료에 효능이 있습니다. > **임상 팁**: 높은 비용과 심각한 골수 억제 가능성 때문에 수의학에서의 사용은 일반적으로 전문 종양학 진료로 제한됩니다.

작용 기전: Gemcitabine is a **cell-cycle phase-specific** antimetabolite that acts primarily during the **S phase** (DNA synthesis) and blocks progression through the G1/S-phase boundary. - It is transported intracellularly and phosphorylated to **dFdCMP**, then to active diphosphate (**dFdCDP**) and triphosphate (**dFdCTP**) metabolites. - **dFdCDP** inhibits **ribonucleotide reductase**, depleting the cellular pool of deoxynucleotides required for DNA synthesis. - **dFdCTP** competes with endogenous deoxycytidine triphosphate (**dCTP**) for incorporation into the elongating DNA strand. Once incorporated, it causes **DNA chain termination** and subsequent apoptosis.

동물 종별 용량

Cats

Carcinomas (in combination with carboplatin) · 2 mg/kg IV over 20-30 minutes · IV · no more than once every 7 days · Doses have ranged widely from 45 mg/m2-800 mg/m2 depending on the study.
Exocrine pancreatic carcinoma (Low dose) · 20-25 mg/m2 or 2 mg/kg · IV · every 7 days · Administer as a 20 minute IV infusion.

Dogs

Carcinomas (in combination with carboplatin) · 2 mg/kg IV over 20-30 minutes · IV · no more than once every 7 days · Doses have ranged widely from 45 mg/m2-800 mg/m2 depending on the study.
Bladder urothelial carcinoma, lymphoma, and various carcinomas (High dose) · 800-900 mg/m2 · IV · every 7-14 days · for 4 doses · Administer over 20-60 minutes.
Bladder urothelial carcinoma, lymphoma, and various carcinomas (Low dose) · 25-50 mg/m2 · IV · once or twice a week · Administer over 20-60 minutes as per protocols.
Carcinomas (Combination therapy) · 2 mg/kg · IV · every 7 days · Administer over 20-30 minutes (in 0.9% NaCl) combined with carboplatin.
Advanced solid tumors · Escalating doses per protocol · IV · single administration or per protocol · Phase 1 dose-escalation trial.

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

금기

Hypersensitivity to gemcitabine
Known hypersensitivity to gemcitabine
Pre-existing bone marrow suppression

이상반응

Myelosuppression (neutropenia and thrombocytopenia; nadir at 3-7 days)
Mild to moderate gastrointestinal toxicity
Retinal hemorrhage
Myelosuppression (neutropenia, thrombocytopenia, anemia)
Gastrointestinal toxicity (vomiting, diarrhea, anorexia)
Retinal haemorrhage
Treatment-related mortality (due to severe complications)

약물 상호작용

Other myelosuppressive agents · Additive toxic effects (myelosuppression, GI toxicity)

모니터링

CBC before each treatment
Fundic exam weekly while on therapy
Baseline renal and hepatic function prior to therapy, and periodically thereafter
Complete Blood Count (CBC) prior to each dose (monitor for myelosuppression)
Hepatic function panel
Renal function panel
Gastrointestinal signs (vomiting, diarrhea, anorexia)
Ophthalmic exam (monitor for retinal haemorrhage)

과용량

There is no known antidote to gemcitabine in an overdose situation. Severe myelosuppression should be expected. Treatment is supportive.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.