레베티라세탐

항경련제

**레베티라세탐(Levetiracetam)**은 수의학에서 주로 보조 요법으로 사용되는 구조적으로 독특한 새로운 항경련제입니다. * **개:** 페노바르비탈이나 브롬화칼륨이 금기이거나 내성이 없는 경우, 또는 난치성 간질의 3차 약물로 사용됩니다. 개에서는 장기간 사용 시 효과가 감소하는 '허니문 효과'가 나타날 수 있으므로 주의가 필요합니다. * **고양이:** 일반적으로 페노바르비탈로 효과가 불충분할 때 2차 추가 약물로 사용되거나, 페노바르비탈에 내성이 없는 경우 단독 요법으로 사용됩니다. **임상 요점:** 간 대사가 거의 없고 시토크롬 P450 효소계에 의존하지 않으므로 간 기능이 손상된 환자에게 매우 적합합니다. 그러나 반감기가 짧아 자주(하루 3번) 투약해야 하므로 보호자에게 부담이 될 수 있습니다.

작용 기전: The exact mechanism of levetiracetam's antiseizure activity is not fully elucidated, but it is distinct from traditional anticonvulsants (which typically affect GABA or ion channels). * Binds specifically to **Synaptic Vesicle Protein 2A (SV2A)** in the central nervous system. * Binding to **SV2A** → modulates neurotransmitter release into the synaptic cleft → selectively prevents hypersynchronization of epileptiform burst-firing and propagation of seizure activity. * It does **not** affect normal neuronal excitability.

동물 종별 용량

Cats

As an add-on to phenobarbital treatment for epilepsy · Initially, 20 mg/kg PO three times daily; slowly increase to effect · PO · TID
As an adjunct to phenobarbital in suspected idiopathic epilepsy · Initially, 20 mg/kg PO three times daily. Monitor as below. If ineffective, increase dose in 20 mg/kg increments. · PO · TID

Dogs

As an add-on treatment for epilepsy in dogs refractory to phenobarbital and bromides · 20 mg/kg PO every 8 hours · PO · q8h
As an add-on treatment for epilepsy in dogs refractory to phenobarbital and/or bromides · 7.1-23.8 mg/kg PO every 8 hours · PO · q8h
Seizure management · 10-20 mg/kg PO q8h · PO · q8h
Seizure management · Initially, 20 mg/kg PO q8h. May increase dose in 20 mg/kg increments until efficacy achieved, side effects become apparent, or the drug becomes cost prohibitive. · PO · q8h
Seizure management · 20 mg/kg PO q8h; may also be given as an IV bolus (20 mg/kg). · PO/IV · q8h
Single-dose pharmacokinetic study · 60 mg/kg IV bolus dose · IV · Once · Well tolerated and achieves plasma drug concentrations within or above the therapeutic range reported for humans for at least 8 hours.
For status epilepticus · Initially, lorazepam at 0.2 mg/kg IV once, followed by a bolus IV loading dose of levetiracetam at 60 mg/kg. · IV · Once

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

투여 경로

POIVRectal

금기

Hypersensitivity to levetiracetam or any of its components
Severe renal disease

이상반응

Sedation (most common in dogs)
Lethargy (most common in cats)
Decreased appetite (most common in cats)
Behavior changes
Gastrointestinal effects
Sedation (dogs)
Ataxia (dogs)
Reduced appetite (cats)
Hypersalivation (cats)
Lethargy (cats)

약물 상호작용

NSAIDs (naproxen, ketorolac) · May increase the risk for seizures (reported in humans; veterinary significance unclear).
Phenobarbital · Significantly increases levetiracetam clearance and reduces its half-life in dogs (from 3.43 hrs to 1.73 hrs); dosage adjustments may be required. · moderate

모니터링

Therapeutic drug monitoring (target range 5-45 mcg/mL) approximately one week after starting, then every 6-12 months (primarily to adjust dosage)
Seizure activity log (frequency, duration, severity)
Routine CBC and basic metabolic panel every 6 months
Adverse effects (sedation, lethargy, appetite changes)
Seizure frequency and severity
Renal function (BUN, Creatinine, SDMA) especially in older patients
Therapeutic drug monitoring is rarely required but can be performed

과용량

Levetiracetam is a relatively safe agent. * **Dogs:** Doses of 1200 mg/kg/day (~20x therapeutic dose) caused only salivation and vomiting. * **Humans:** Doses of 6000 mg/kg caused drowsiness. Other reported effects include depressed consciousness, agitation, aggression, and respiratory depression. * **Treatment:** Basically supportive. The drug can be removed with hemodialysis. Contact an animal poison control center for significant overdoses.

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