๋ง๋ฐ์ฝ์๋ธ
๋ง๋ฐ์ฝ์๋ธ(Mavacoxib)๋ ์ฝ์๋ธ ๊ณ์ด์ ๋งค์ฐ ๋ ํนํ ์ด์ฅ๊ธฐ ์์ฉ ๋น์คํ ๋ก์ด๋์ฑ ํญ์ผ์ฆ์ (NSAID)์ ๋๋ค. ๋งค์ผ ํฌ์ฌํ๋ ๊ธฐ์กด์ NSAID์ ๋ฌ๋ฆฌ ์ 1ํ ํฌ์ฌํ๋๋ก ์ค๊ณ๋์ด ๋งค์ผ ์ฝ์ ๋จน์ด๊ธฐ ์ด๋ ค์ด ๋ณดํธ์์๊ฒ ํ๋ฅญํ ๋์์ด ๋ฉ๋๋ค. **์์ ์์ :** ๋ฐ๊ฐ๊ธฐ๊ฐ ๋งค์ฐ ๊ธธ๊ธฐ ๋๋ฌธ์(ํ๊ท 16~17์ผ) ๋ถ์์ฉ์ด ๋ฐ์ํ ๊ฒฝ์ฐ ํฌ์ฝ ์ค๋จ ํ์๋ ์์ฃผ๊ฐ ์ง์๋ ์ ์์ต๋๋ค. ๋ฐ๋ผ์ ์ ์คํ ํ์ ์ ํ์ด ํ์์ ์ด๋ฉฐ, ์ผ๋ฐ์ ์ผ๋ก ๊ธ์ฑ ํต์ฆ๋ณด๋ค๋ ๋ง์ฑ ๊ณจ๊ด์ ์ผ ๊ด๋ฆฌ์ ์ฌ์ฉ๋ฉ๋๋ค.
์์ฉ ๊ธฐ์ : Mavacoxib is a **COX-2 selective inhibitor** (coxib). * **Arachidonic Acid Cascade:** It selectively inhibits the **cyclooxygenase-2 (COX-2)** enzyme โ decreases the production of pro-inflammatory prostaglandins (such as PGE2) โ reduces pain, inflammation, and fever. * **COX-1 Sparing:** At therapeutic dosages, it relatively spares **COX-1**, the constitutive enzyme responsible for synthesizing prostaglandins that protect the gastric mucosa, support platelet function, and maintain normal renal blood flow. However, COX-selectivity is relative and can be lost at higher doses or in susceptible individuals.
๋๋ฌผ ์ข ๋ณ ์ฉ๋
- Any ยท Do not use ยท PO ยท N/A ยท N/A ยท Contraindicated in cats.
- Pain and inflammation associated with degenerative joint disease in dogs aged 12 months or more in cases where continuous treatment exceeding one month is indicated ยท 2 mg/kg PO given immediately before or with the dog's main meal. The treatment should be repeated 14 days later; thereafter the dosing interval is one month. ยท PO ยท Day 1, Day 14, then monthly ยท A treatment cycle should not exceed 7 consecutive doses (6.5 months). ยท Care should be taken to ensure that the tablet is ingested. THIS IS not a daily NSAID.
- Pain and inflammation associated with degenerative joint disease (osteoarthritis) ยท 2 mg/kg ยท PO ยท q14d for 2 doses, then q1month ยท Maximum of 7 doses total ยท Should be given immediately before or with the dog's main meal. Treatment can potentially be re-started after a 1-month break from dosing.
์ฉ๋์ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์ฐธ๊ณ ์๋ฃ์ ๋๋ค. ํญ์ ์ต์ ๋ผ๋ฒจ๊ณผ ๊ฐ๋ณ ํ์์ ๋ํด ํ์ธํ์ญ์์ค.
ํฌ์ฌ ๊ฒฝ๋ก
๊ธ๊ธฐ
- Dogs less than 12 months of age
- Dogs less than 5 kg body weight
- Gastrointestinal disorders including ulceration and bleeding
- Evidence of a hemorrhagic disorder
- Impaired renal or hepatic function
- Cardiac insufficiency
- Hypersensitivity to mavacoxib, sulfonamides, or excipients
- Pregnant, breeding, or lactating animals
- Dehydrated, hypovolemic, or hypotensive animals
- Dehydrated, hypovolaemic, or hypotensive patients
- Gastrointestinal disease or ulceration
- Blood clotting disorders
- Liver disease (prolongs metabolism and causes accumulation)
- Renal disease (requires careful evaluation, generally avoid)
- Pregnant or lactating animals
์ด์๋ฐ์
- Inappetence
- Diarrhea
- Vomiting
- Depression
- Renal toxicity
- Gastrointestinal ulceration
- Gastrointestinal ulceration or bleeding
- Vomiting and diarrhoea
- Renal toxicity (especially if dehydrated or hypotensive)
- Hepatic accumulation (in poor metabolizers)
- Theoretical risk of precipitating cardiac failure
์ฝ๋ฌผ ์ํธ์์ฉ
- ACE Inhibitors (e.g., enalapril, benazepril) ยท NSAIDs can reduce effects on blood pressure and potentially reduce renal blood flow, increasing the risk for renal injury.
- Aspirin ยท May increase the risk of gastrointestinal toxicity (ulceration, bleeding, vomiting, diarrhea). Long washout periods are warranted when switching.
- Corticosteroids (e.g., prednisone) ยท May increase the risk of gastrointestinal toxicity (ulceration, bleeding, vomiting, diarrhea). Concurrent use is contraindicated.
- Digoxin ยท NSAIDs may increase serum levels of digoxin.
- Fluconazole ยท May increase plasma levels of mavacoxib (extrapolated from celecoxib data in humans).
- Furosemide ยท NSAIDs may reduce saluretic and diuretic effects.
- Methotrexate ยท Serious toxicity has occurred when NSAIDs have been used concomitantly; use together with extreme caution.
- Nephrotoxic Drugs (e.g., aminoglycosides, amphotericin B) ยท May enhance the risk of nephrotoxicity development.
- Other NSAIDs ยท May increase the risk of gastrointestinal toxicity. Do not administer other NSAIDs within 1 month of the last administration of mavacoxib. ยท major
- Glucocorticoids ยท Increased risk of severe gastrointestinal ulceration and bleeding. ยท major
- Aminoglycosides ยท Increased risk of nephrotoxicity. ยท major
๋ชจ๋ํฐ๋ง
- Baseline and periodic CBC and serum chemistry (including BUN/serum creatinine, and liver function assessment)
- Baseline history and physical
- Efficacy of therapy
- Adverse effect monitoring via client
- Baseline and periodic renal function (BUN, Creatinine, SDMA, USG)
- Baseline and periodic hepatic function (ALT, ALP, Bilirubin)
- Clinical signs of GI ulceration (vomiting, melaena, anorexia)
- Hydration status and blood pressure (especially during anaesthesia)
๊ณผ์ฉ๋
In safety studies, repeated doses of 5 and 10 mg/kg did not demonstrate adverse events. At **15 mg/kg**, vomiting, softened/mucoid feces, and decreased renal function were noted. Doses of **25 mg/kg** caused GI ulceration, with one fatality from GI perforation and peritonitis. * **Management:** Manage as with other NSAID toxicity (emetics, activated charcoal, GI protectants, fluid diuresis). * **Important:** Because of the drug's very long duration of effect, prolonged monitoring and treatment may be required. Consulting a veterinary poison center is highly recommended.
VetSheet ์ฝ๋ฌผ ๋ ํผ๋ฐ์ค๋ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์์ฌ๊ฒฐ์ ๋ณด์กฐ ๋๊ตฌ์ด๋ฉฐ, ์ ๋ฌธ์ ํ๋จ์ด๋ ์ ์กฐ์ฌ์ ์ต์ ๋ผ๋ฒจ์ ๋์ ํ์ง ์์ต๋๋ค.