탄산란탄

인 결합제

탄산란탄은 주로 말기 신질환(ESRD) 환자의 고인산혈증을 관리하는 데 사용되는 경구용 인 결합제입니다. 식이 인 제한이 만성 신장 질환(CKD) 관리의 기본이지만, 식이요법만으로 불충분하거나 환자가 처방식을 거부할 때 인 결합제가 지시됩니다. > **임상 요점:** 칼슘 기반 결합제(고칼슘혈증 유발 가능)나 알루미늄 기반 결합제(장기 사용 시 알루미늄 독성 위험)와 달리, 란탄은 칼슘과 알루미늄을 포함하지 않아 수의 임상에서 고인산혈증의 장기 관리에 매력적인 선택지입니다.

작용 기전: Lanthanum carbonate acts locally in the gastrointestinal tract. * It dissociates in the acidic environment of the upper GI tract (stomach) to release **lanthanum ions (La³⁺)**. * These ions bind to dietary phosphate → forming highly insoluble **lanthanum phosphate complexes**. * These complexes cannot cross the intestinal mucosa and are subsequently eliminated in the feces, thereby reducing net intestinal absorption of phosphorus.

동물 종별 용량

Cats

Phosphate binder · 200 mg (total dose) PO (on/in food) 2-3 times daily. · PO · 2-3 times daily · Anecdotally appears safe and effective.
Phosphate binder (using Renalzin) · 2 mLs (400 mg) applied in the cat's food, once or twice daily depending on the cat's feeding regimen. · PO · once or twice daily
Chronic kidney disease (Hyperphosphataemia) · 400-800 mg/cat/day · PO · divided according to feeding schedule (give some with every meal) · Chronic · Recommended starting dose is 400 mg per day. It is important to give some with every meal.

Dogs

Chronic kidney disease (Hyperphosphataemia) · 100 mg/kg/day · PO · divided between meals · Chronic · Dose adjustments should be based on serum phosphate levels monitored at 4-6 week intervals.

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

투여 경로

금기

Patients with non-intact GI tract (e.g., GI ulcers, colitis) - use with caution due to increased risk of systemic absorption
Acute renal crisis (patients should be stabilized first)

이상반응

Vomiting
Nausea
Inappetence
None known according to the monograph
Gastrointestinal upset (nausea, vomiting, diarrhea, or constipation) may occur (Clinical Pearl)

약물 상호작용

Allopurinol · Potential decreased absorption; separate dosing by 2 hours
Chloroquine · Potential decreased absorption; separate dosing by 2 hours
Corticosteroids · Potential decreased absorption; separate dosing by 2 hours
Digoxin · Potential decreased absorption; separate dosing by 2 hours
Ethambutol · Potential decreased absorption; separate dosing by 2 hours
Fluoroquinolones · Potential decreased absorption; separate dosing by 2 hours
H-2 Antagonists (ranitidine, famotidine) · Potential decreased absorption; separate dosing by 2 hours
Iron Salts · Potential decreased absorption; separate dosing by 2 hours
Isoniazid · Potential decreased absorption; separate dosing by 2 hours
Penicillamine · Potential decreased absorption; separate dosing by 2 hours
Phenothiazines · Potential decreased absorption; separate dosing by 2 hours
Tetracyclines · Potential decreased absorption; separate dosing by 2 hours
Thyroid Hormones · Potential decreased absorption; separate dosing by 2 hours

모니터링

Serum phosphorous
Serum potassium
Serum calcium
Serum bicarbonate
Serum chloride
Serum phosphate levels (at 4-6 week intervals to adjust dosage and achieve target concentrations)
Renal parameters (BUN, Creatinine, SDMA)
Serum calcium levels

과용량

No specific information located, but acute overdose is likely tolerated with potential for GI effects. Only supportive treatment should be required. In cats, oral dosages up to 1 gram/kg were tolerated, but repeated vomiting occurred at 2 grams/kg.

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