이소플루프레돈 아세테이트

코르티코스테로이드 / 글루코코르티코이드

**이소플루프레돈 아세테이트**는 주로 대동물(소, 말, 돼지) 의학에서 사용되는 강력한 불소화 합성 글루코코르티코이드입니다. * **효능**: 히드로코르티손의 약 **17배**, 프레드니솔론의 **10배**에 달하는 항염 효과를 가집니다. 글루코코르티코이드 활성은 히드로코르티손의 50배로 평가됩니다. * **임상적 유용성**: 강력한 항염 및 면역 억제 효과로 인해 자주 사용됩니다. 적응증윰로는 소 케톤증의 보조 치료, 근골격계 염증, 급성 과민 반응, 심각한 독성을 동반한 중증 감염, 말의 재발성 기도 폐쇄(RAO) 등이 있습니다. * **임상 팁**: 덱사메타손이나 베타메타손과 달리 조기 분만을 유발할 가능성이 적지만, 임신 후기에는 사용을 피해야 합니다. 특히 유의미한 **미네랄로코르티코이드 활성**을 유지하고 있어, 젖소의 경우 단일 투여만윰로도 **저칼륨혈증**에 빠질 위험이 매우 높습니다.

작용 기전: Isoflupredone exerts its effects via classic genomic and non-genomic steroid pathways: * **Anti-inflammatory (Glucocorticoid Receptor - GR)**: Binds to cytosolic **GR** → translocates to the nucleus → induces transcription of **lipocortin-1 (annexin A1)**. Lipocortin-1 inhibits **phospholipase A2**, thereby blocking the release of arachidonic acid and halting the production of inflammatory prostaglandins and leukotrienes. It also transrepresses pro-inflammatory transcription factors like **NF-κB** and **AP-1**. * **Mineralocorticoid Effects (Mineralocorticoid Receptor - MR)**: Binds to **MR** in the distal renal tubules → upregulates Na+/K+ ATPase and ENaC channels → promotes **sodium retention** and **potassium excretion** (leading to hypokalemia). * **Metabolic**: Stimulates hepatic gluconeogenesis (useful in bovine ketosis) and decreases peripheral glucose utilization.

동물 종별 용량

Cattle

Labeled systemic indications · 10-20 mg (total dose) · IM · repeated in 12 to 24 hours if indicated · according to the size of the animal and severity of the condition

Horses

Labeled systemic indications · 5-20 mg (total dose) · IM · repeated as necessary
Intrasynovial administration · 5-20 mg or more · Intrasynovial · depending on the size of the joint cavity
Intraarticular administration · 4-20 mg · Intraarticular · has a short to medium duration of action
Treatment of 'heaves' (RAO) · 10-14 mg (total dose) · IM · once daily · for a horse weighing between 450-500 kg
Treatment of recurrent airway obstruction (RAO) · 0.03 mg/kg · IM · once daily · 14 days · Patients developed significant decreases in serum potassium

Swine

Labeled systemic indications · 5 mg (total dose) · IM · for a 300 lb. animal. Adjust dose proportionally for a smaller or larger animal.

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

투여 경로

IMIntrasynovialIntraarticular

금기

Systemic fungal infections (unless used for Addison's replacement)
Idiopathic thrombocytopenia (when administered IM)
Hypersensitivity to the compound
Downer cows or animals susceptible to hypokalemia
Calves to be processed into veal
Late stages of pregnancy (relative contraindication)

이상반응

Hypokalemia (even with single doses)
Reduced milk production
Delayed wound healing
Gastrointestinal ulceration
Increased infection rates
Diabetes mellitus exacerbation / hyperglycemia
Pancreatitis
Hepatopathy
Renal dysfunction
Osteoporosis
Laminitis (horses)
Hypothyroidism
Hyperlipidemia
Decreased growth in young animals
Premature parturition with retained placenta (if used in late pregnancy)

약물 상호작용

Digitalis glycosides (digoxin) · Increased chance of digitalis toxicity may occur should hypokalemia develop; diligent monitoring of potassium and digitalis glycoside levels is recommended
Potassium-depleting diuretics (furosemide, thiazides) · Administered concomitantly with glucocorticoids may cause hypokalemia
Salicylates · Glucocorticoids may reduce salicylate blood levels
Ulcerogenic drugs (e.g., NSAIDs) · With glucocorticoids may increase the risk of gastrointestinal ulceration
Vaccines, toxoids, bacterins · A diminished immune response may occur; patients receiving immunosuppressive dosages should generally not receive live attenuated-virus vaccines

모니터링

Efficacy and adverse effects
Serum potassium (highly recommended due to hypokalemia risk)
Renal and liver function
CBC
Blood glucose
Serum electrolytes
ACTH stimulation tests (to determine HPA axis suppression)
Thyroid hormone monitoring (if use is prolonged)

과용량

A single overdose of isoflupredone is unlikely to cause harmful effects. Should clinical signs require intervention, use supportive treatment. Chronic usage of glucocorticoids can lead to serious adverse effects, generally manifested as signs of hyperadrenocorticism.

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