구아이페네신

주사용 근이완제 / 경구용 거담제

**구아이페네신**(글리세릴 구아이아콜레이트 또는 GG로도 알려짐)은 이중 목적의 약리학적 제제입니다. 수의학에서는 주로 대동물의 짧은 마취 절차(30-60분) 동안 흥분 없는 유도 및 회복을 촉진하기 위한 **주사용 근이완제**로 사용됩니다. * **마취 보조제**: 횡격막 기능을 손상시키지 않으면서 골격근 이완을 제공합니다. * **경구용 거담제**: 점액을 묽게 하여 호흡기 질환을 관리하기 위해 인의 및 수의학 모두에서 사용되지만, 임상적 효능에 대한 결정적인 증거는 여전히 논쟁의 여지가 있습니다. **임상 요점**: 구아이페네신은 그 자체로 마취제가 아닙니다. 마취 전 투약 및 마취제의 활성을 강화하므로 균형 마취 프로토콜(예: "트리플 드립" 또는 GKX)에 사용해야 합니다. 가벼운 내인성 진통 및 진정 효과가 있습니다.

작용 기전: * **Muscle Relaxation**: Acts centrally by depressing or blocking nerve impulse transmission at the **internuncial neuron** level of the subcortical areas of the brain, brainstem, and spinal cord → selective relaxation of skeletal muscles (including laryngeal and pharyngeal muscles, easing intubation) while sparing respiratory muscles. * **Expectorant Action**: Believed to stimulate gastric vagal receptors → triggers efferent parasympathetic reflexes → increases respiratory tract fluid volume and decreases mucus viscosity → facilitates removal of secretions via ciliary action and coughing.

동물 종별 용량

Sheep

Using 'GKX' for induction/maintenance · Induce with 2.2 mL/kg IV. Maintain with approximately 2.2 mL/kg/hr IV · IV · CRI · Mix 1000 mL of 5% (50 mg/mL) guaifenesin with 1000 mg of ketamine ± 0-100 mg of xylazine.
Using 'GKX' · Administer at a rate of 2-4 mL/kg · IV · Once then slowed · Given rapidly until animal is recumbent and then slowed to maintain desired anesthesia plane.

Goats

Using 'GKX' for induction/maintenance · Induce with 2.2 mL/kg IV. Maintain with approximately 2.2 mL/kg/hr IV · IV · CRI · Mix 1000 mL of 5% (50 mg/mL) guaifenesin with 1000 mg of ketamine ± 0-100 mg of xylazine.
Using 'GKX' · Administer at a rate of 2-4 mL/kg · IV · Once then slowed · Given rapidly until animal is recumbent and then slowed to maintain desired anesthesia plane.

Cattle

General · 55-110 mg/kg · IV · Once

Horses

General anesthesia adjunct · 110 mg/kg · IV · Once · Give first 1/3-1/2 of dose until horse falls gently, then give remainder unless respiratory or cardiovascular effects are observed.
Muscle relaxation in balanced anesthesia · A CRI of ketamine at 0.8-2.3 mg/kg/hr with guaifenesin at 18-60 mg/kg/hr · IV · CRI · May reduce MAC requirements by 50%.

투여 경로

IVPO

금기

Concurrent use with physostigmine
Concentrations greater than 5% in ruminants (due to hemolysis risk)

이상반응

Mild hypotensive effect
Increase in cardiac rate
Thrombophlebitis (IV administration)
Perivascular tissue reaction
Hemolysis (especially in ruminants with >5% solutions)
Increased gastrointestinal motility

약물 상호작용

Physostigmine · Contraindicated in horses receiving guaifenesin; exact interaction mechanism not elucidated by manufacturer.
Anticholinesterase agents (neostigmine, pyridostigmine, edrophonium) · Theoretically contraindicated based on the physostigmine interaction.

모니터링

Level of muscle relaxation
Cardiac rate
Respiratory rate

과용량

* **Margin of Safety**: Reportedly 3 times the usual dose. * **Clinical Signs**: Apneustic breathing, nystagmus, hypotension, and contradictory muscle rigidity are associated with toxic levels. * **Toxicity Reports**: In dogs receiving 415-830 mg/kg, signs included hypothermia, mild tremors, ataxia, and vomiting. In cats receiving 132 mg/kg, signs included lethargy and anorexia. * **Treatment**: No specific antidote is available. Treatment is entirely **supportive** until the drug is cleared to sub-toxic levels.

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