3% 과산화수소

경구 최토제 / 국소 소독제

3% 과산화수소는 널리 사용되는 국소 소독제이며, 수의학에서는 주로 개에서 **응급 경구 최토제**로 자주 사용됩니다. * **임상 요점:** 가정 상비약이지만, 최토제로서의 사용은 일반적으로 즉각적인 수의학적 치료가 불가능하고 신속한 오염 제거가 필요한 상황으로 제한됩니다. 임상 환경에서는 효능이 더 높고 심각한 점막 자극 위험이 낮은 **아포모르핀**(개) 또는 **크실라진/덱스메데토미딘**(고양이)과 같은 중추성 최토제가 선호됩니다. * **고양이 주의사항:** 심각한 괴사성 출혈성 위염을 유발할 위험이 높기 때문에 독성학자들은 고양이에게 사용하는 것을 점점 더 권장하지 않습니다. * **효능:** 구토 유발에 성공했다고 해서 위 내용물이 완전히 비워졌다는 것을 보장하지는 않습니다. 섭취한 약물/독소의 상당량이 남아 있거나 이미 흡수되었을 수 있습니다.

작용 기전: Orally administered hydrogen peroxide (3%) induces a vomiting reflex via direct irritant effects on the oropharynx and gastric lining. * **Mechanism:** H₂O₂ interacts with the enzyme **catalase** present in tissue and blood → rapid release of water (H₂O) and oxygen gas (O₂) → massive bubbling and gastric distension. * The combination of direct mucosal irritation and sudden gastric distension stimulates visceral afferent vagal and sympathetic nerves → signals the **emetic center** in the medulla oblongata → triggers the vomiting reflex. * Emesis typically ensues within 10 minutes of administration.

동물 종별 용량

Cats

As an emetic · 1 teaspoon (5 mL) per 5 lbs. (2.3 kg) of body weight (approximately 2 mL/kg) not to exceed 3 tablespoons (45 mL). · PO · can be repeated once if not initially successful · Vomiting usually occurs within minutes. Note: Use in cats is generally discouraged due to risk of severe gastric ulceration.
As an emetic · 1-2 mL/kg PO up to 2-3 times · PO · up to 2-3 times
As an emetic · 1-5 mL/kg PO; generally not to exceed 50 mL for dogs and 10 mL for cats; may repeat one time if after 10 minutes emesis does not occur. · PO · may repeat one time if after 10 minutes emesis does not occur · Inducing emesis is most effective if administered after a small meal.

Ferrets

As an emetic · 1 teaspoon (5 mL) per 5 lbs. (2.3 kg) of body weight (approximately 2 mL/kg) not to exceed 3 tablespoons (45 mL). · PO · can be repeated once if not initially successful · Vomiting usually occurs within minutes.
As an emetic · 1-2 mL/kg PO up to 2-3 times · PO · up to 2-3 times
As an emetic · 1-5 mL/kg PO; may repeat one time if after 10 minutes emesis does not occur. · PO · may repeat one time if after 10 minutes emesis does not occur · Inducing emesis is most effective if administered after a small meal.

Swine

As an emetic (pot-bellied pigs) · 1 teaspoon (5 mL) per 5 lbs. (2.3 kg) of body weight (approximately 2 mL/kg) not to exceed 3 tablespoons (45 mL). · PO · can be repeated once if not initially successful · Vomiting usually occurs within minutes.

투여 경로

POtopical

금기

Animals already vomiting
Severely lethargic, comatose, or debilitated animals (e.g., respiratory distress, decreased swallowing reflex, bradycardia)
Seizuring or hyperactive animals
Recent abdominal surgery
Megaesophagus
Ingestion of corrosives/caustics (e.g., acids, alkalis)
Ingestion of sharp objects
Ingestion of bagged illicit drugs
Ingestion of hydrocarbons or petroleum distillates
Rodents or rabbits (incapable of vomiting)

이상반응

Aspiration of hydrogen peroxide solution or stomach contents
Vasovagal (bradycardic) response in animals with cardiovascular compromise
Gastric ulceration (particularly in cats)
Gastric-dilatation-volvulus (GDV) in dogs

약물 상호작용

ACETYLCYSTEINE (oral) · Hydrogen peroxide can oxidize acetylcysteine in the gut; alternative emetics are preferred for acetaminophen overdoses.
ANTIEMETICS (e.g., ondansetron, maropitant) · Preadministration or ingestion of these products may negate the emetic effects of hydrogen peroxide.

모니터링

Efficacy (emesis, signs associated with toxicity of the substance ingested, blood levels of toxicants if applicable)
Heart rate and respiration rate
Thoracic auscultation after emesis (to monitor for aspiration pneumonia)

과용량

Hydrogen peroxide 3% solution is relatively non-toxic after oral ingestion, though it can cause gastric irritation, vomiting, and rarely gastric ulceration or GDV. > **DANGER:** Hydrogen peroxide in concentrations of **10% or greater** (such as hair bleach or industrial peroxide) can be very corrosive, causing severe burns to the oral and gastric mucosa, and can induce fatal oxygen emboli after oral ingestion.

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