이미도카브

항원충제

**이미도카브(Imidocarb)**는 수의학에서 진드기 매개 원충 감염 치료에 주로 사용되는 디아미딘계 항원충제입니다. **주요 임상 적용:** - **바베시아증(Babesiosis)**: 개 바베시아(*Babesia canis*) 및 말과 양의 바베시아 종에 대해 높은 효과를 보입니다. - **세포주혈원충증(Cytauxzoonosis)**: 고양이의 *Cytauxzoon felis* 감염 치료에 사용되며, 종종 종합 치료 프로토콜의 일부로 활용됩니다. - **기타 용도**: 에를리히아, 헤파토준 및 고양이 혈구마이코플라스마의 대체 또는 보조 치료제로 사용되기도 합니다. *임상 팁*: 개 바베시아에는 매우 효과적이지만, 깁슨 바베시아(*B. gibsoni*)에 대한 효과는 일반적으로 떨어집니다. 아메리카 헤파토준의 피낭 단계는 제거하지 못합니다.

작용 기전: Imidocarb acts by directly targeting the **nucleic acids** of susceptible protozoal organisms. - It binds to and intercalates with **DNA** → causing the double helix to unwind and denature. - This structural damage → **inhibits cellular repair and replication** → leading to parasite death. - *Mechanistic Note*: As a diamidine derivative, it may also interfere with polyamine synthesis and function, further disrupting the parasite's metabolic pathways.

동물 종별 용량

Cats

Cytauxzoon felis · 3-4 mg/kg · IM · repeated 7 days after initial dose · Efficacy not proven. Cholinergic effects can be mitigated by pre-treating with atropine. Must also give supportive therapy (IV fluids, prophylactic heparin, nutritional/nursing care, analgesia, and potentially transfusion).
Cytauxzoon felis · 5 mg/kg · IM · once and then 14 days later
Feline hemoplasmosis (Mycoplasma haemofelis, M. haemominutum) · 5 mg/kg · IM, SC · every 14 days · until able to maintain a normal PCV · Alternative for cats intolerant of doxycycline.
Feline clinical ehrlichiosis or anaplasmosis · 5 mg/kg · IM · every 14 days · for at least 2-4 treatments · Alternative to doxycycline.
Treatment of large babesial species infection · 2.5 mg/kg · IM · once · 1 dose · Dose based on imidocarb dipropionate. Can improve clinical signs. Alternative agents are preferable for smaller species (e.g., B. felis).

Sheep

Babesiosis · 1.2 mg/kg · IM · repeat in 10-14 days

Horses

Equine piroplasmosis (Babesia caballi; Babesia equi) · 2.2 mg/kg · IM · once · Will generally allow clinical signs to subside.
Equine piroplasmosis (Babesia caballi) · 2 mg/kg · IM · once a day · for 2 days · To eliminate B. caballi.

투여 경로

IMSC

금기

Intravenous (IV) administration
Patients exposed to cholinesterase-inhibiting drugs
Patients exposed to pesticides or certain chemicals

이상반응

Pain and inflammation at the injection site (rarely ulceration)
Salivation/drooling
Nasal drip/discharge
Vomiting (usually brief)
Panting
Diarrhea
Restlessness
Lacrimation and sweating (horses)
Severe renal tubular or hepatic necrosis (rare)
Salivation (drooling)
Vomiting
Injection site inflammation (mild to severe, potential ulceration)
Anaphylactoid reactions (reported in cattle)

약물 상호작용

Cholinesterase-inhibiting drugs (e.g., pyridostigmine) · Increased risk of severe cholinergic toxicity; concurrent use is contraindicated.
Pesticides and chemicals · May exacerbate cholinergic adverse effects and toxicity.
Anticholinesterases · Increased risk of severe cholinergic toxicity · major

모니터링

Clinical efficacy (resolution of parasitemia and clinical signs)
Adverse effect profile (cholinergic signs, injection site reactions)
Creatine kinase (CK) levels (may be significantly increased post-IM injection)
Liver and kidney function (especially in cases of suspected overdose or pre-existing disease)
Resolution of clinical signs of babesiosis (fever, anemia, lethargy)
Blood smears or PCR to confirm parasite clearance
Injection site for signs of inflammation, necrosis, or ulceration
Immediate post-injection monitoring for cholinergic crisis

과용량

**Acute Toxicity & Overdose Signs:** - **Dogs**: At 1.5X the labeled dose (9.9 mg/kg), dogs exhibited signs of liver injury (mildly elevated liver enzymes), pain/swelling at the injection site, and vomiting. - **General Overdose/Chronic Toxicity**: Presents primarily with severe **cholinergic signs** (vomiting, weakness, lethargy, excessive salivation) or adverse changes in liver, kidney, lung, or intestinal function. - **Horses**: The reported LD-50 is 16 mg/kg. **Treatment:** - **Atropine** or other antimuscarinics may be highly useful to treat the cholinergic signs associated with imidocarb toxicity. - Provide symptomatic and supportive care for organ dysfunction.

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