그리세오풀빈

항진균제

그리세오풀빈은 수의학에서 주로 피부, 털, 발톱의 **피부사상균 감염**(백선)을 치료하는 데 사용되는 정진균성 항생제입니다. **주요 임상 포인트:** * 피부사상균(*Trichophyton*, *Microsporum*, *Epidermophyton* 등)에 대해 높은 특이성을 가집니다. * 세균, 기타 병원성 진균 또는 *말라세지아* 효모에는 **효과가 없습니다**. * **임상 팁:** 심각한 부작용(특히 골수 억제 및 기형 유발성)의 가능성과 장기 치료의 필요성 때문에, 현대 수의학에서는 **이트라코나졸** 및 **테르비나핀**과 같은 더 안전한 신형 항진균제로 점차 대체되고 있습니다. * 위장관 흡수율의 차이로 인해 **미세입자(microsize)**와 **초미세입자(ultramicrosize)** 제형 간의 투여량이 크게 다릅니다.

작용 기전: Griseofulvin is a fungistatic agent. It enters susceptible fungal cells and binds to **tubulin**, which disrupts the structure of the **mitotic spindle** → arresting the metaphase of cell division. Additionally, griseofulvin binds to newly synthesized **keratin** in the host. As new skin, hair, and nails grow, the keratin-griseofulvin complex makes these newly formed tissues resistant to fungal invasion, allowing the infected, older tissues to be shed.

동물 종별 용량

Cats

Susceptible dermatophytic infections · Microsize: 50-120 mg/kg PO; divided daily. Ultramicrosize: 10-15 mg/kg PO twice daily. · PO · divided daily or twice daily · 4-6 weeks or longer · Give with a fatty meal. Treat until culture is negative.
Susceptible dermatophytic infections · Microsize: 50 mg/kg PO once daily or 25 mg/kg PO q12h for 42-70 days; Ultramicrosize: 5-10 mg/kg PO once daily for 42 days. · PO · once daily or q12h · 42-70 days · Give following a fatty meal or administration of corn oil. Continue for at least 2 weeks after resolution of signs and at least 5 months for onychomycosis.
Susceptible dermatophytic infections · Microsize: 50 mg/kg PO once daily with fatty meal. · PO · once daily · Prolonged · Used with topical therapy. May double dose in resistant cases. If GI distress occurs may divide dose and give twice daily with food. Begin taking cultures after 4 weeks. Continue therapy for 2 weeks beyond clinical cure and when 2-3 negative cultures are obtained at weekly intervals.
Feline eosinophilic granuloma complex · Microsize: 25 mg/kg PO twice daily with food. · PO · twice daily · At least one month · Give at least for one month to judge efficacy.

Cattle

Susceptible dermatophytic infections · Ultramicrosize: 10-20 mg/kg PO once daily for 1-2 weeks. 100 mg/kg PO given twice (or more) 1 week apart may also be effective. · PO · once daily or weekly · 1-2 weeks · Not FDA-approved for use in food animals and can be very expensive.
Susceptible dermatophytic infections · 20 mg/kg PO once daily for 6 weeks · PO · once daily · 6 weeks

Horses

투여 경로

금기

Pregnancy (known teratogen)
Known hypersensitivity to griseofulvin
Hepatocellular failure
Horses intended for food

이상반응

Anorexia
Vomiting
Diarrhea
Anemia
Neutropenia
Leukopenia
Thrombocytopenia
Depression
Ataxia
Hepatotoxicity
Dermatitis/photosensitivity
Toxic epidermal necrolysis
Teratogenesis

약물 상호작용

Alcohol · Griseofulvin may potentiate the effects of alcohol.
Aspirin · Griseofulvin may decrease salicylate levels.
Cyclosporine · Griseofulvin may decrease cyclosporine levels.
Phenobarbital · May decrease griseofulvin blood concentrations by inducing hepatic microsomal enzymes and/or reducing absorption. Dosage adjustment may be necessary.
Theophylline · May decrease theophylline half-life and levels in some patients.
Warfarin · May reduce the anticoagulant activity of coumarin anticoagulants; adjustment may be required.

모니터링

Clinical efficacy; fungal culture
Adverse effects
CBC; before therapy and q1-3 weeks during therapy
Liver enzymes (if indicated)

과용량

Specifics regarding acute toxicity are limited. Significant overdoses should be managed with gut emptying, activated charcoal, and cathartic administration unless contraindicated. Horses have tolerated 100 mg/kg PO for 20 days without apparent ill effect.

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