메글루민 안티모니에이트

5가 안티몬계 항리슈만편모충 약물

메글루민 안티모니에이트는 개에서 **리슈만편모충증(Leishmaniasis)** 치료에 사용되는 5가 안티몬 화합물입니다(알로푸리놀과 병용 또는 단독 사용). * **임상 요점**: 병원체를 완전히 제거하기는 어려우며, 치료 기간이 길고 비용이 많이 들 수 있습니다. * **내성**: 치료에 대한 내성이 보고되었으며, 알로푸리놀과의 병용이 내성 발생 위험을 줄일 수 있습니다. * **안전성**: 심장, 간 또는 신장 기능 부전 환자에게는 상대적 금기이며 극도의 주의가 필요합니다.

작용 기전: Meglumine antimoniate selectively inhibits leishmanial enzymes required for **glycolytic and fatty acid oxidation** → disruption of parasite bioenergetics → decreased ATP production → death of the organism. * **Synergy**: When used with allopurinol (a leishmaniostatic agent that disrupts RNA synthesis), the combination provides synergistic efficacy and helps prevent the emergence of resistant strains. * **Mechanistic Pearl**: While the exact mechanism remains partially elucidated, it is widely believed that pentavalent antimony (SbV) acts as a prodrug and is reduced to the more toxic and active **trivalent antimony (SbIII)** within the acidic environment of the macrophage phagolysosome, where the amastigotes reside.

동물 종별 용량

Cats

Leishmaniosis (off-label) · 50 mg/kg · SC · q24h · 3-4 weeks · Use with extreme caution; cats may be more sensitive to toxicity.

Dogs

Leishmaniasis (First line treatment) · 75-100 mg/kg SC once daily for 4-8 weeks, with allopurinol (10 mg/kg PO twice daily for at least 6-12 months. · SC · q24h · 4-8 weeks · Used in combination with allopurinol.
Leishmaniasis · 100 mg/kg SC daily for 3-4 weeks; better results are obtained with longer durations (4-6 weeks) of treatment. Protocol with allopurinol may reduce relapse rates: meglumine antimoniate as above with allopurinol at 20-40 mg/kg PO daily for a minimum of 3 weeks. Followed with long-term treatment with allopurinol (alone) at 20-40 mg/kg PO daily or intermittently (one week treatment per month). · SC · q24h · 3-6 weeks · Longer duration (4-6 weeks) yields better results.
Leishmaniasis · 100 mg/kg/day SC until resolution; with allopurinol at 20 mg/kg PO q12h for 9 months. · SC · q24h · Until resolution · Used in combination with allopurinol.
Leishmaniosis · 75-100 mg/kg · SC · q24h (or divided q12h) · 3-4 weeks · Often used in combination with allopurinol (10 mg/kg PO q12h for 6-12 months).

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

투여 경로

SCIM

금기

Previous hypersensitivity to meglumine antimoniate
Severe renal, hepatic, or cardiac failure (relative contraindication; weigh risks vs. benefits)
Severe renal impairment
Hepatic failure
Cardiac disease

이상반응

Injection site reactions (cutaneous abscesses, cellulitis, pain)
Lethargy
Gastrointestinal effects (inappetence, vomiting)
Transient increases in liver enzymes
Nephrotoxicity (tubular damage, proximal tubule cell vacuolization, coagulative necrosis)
Pain and swelling at the injection site
Nephrotoxicity (proteinuria, elevated BUN/creatinine)
Anorexia
Vomiting
Hepatotoxicity (rare)
Myalgia/arthralgia

약물 상호작용

Agents that can prolong QT interval (e.g., tricyclic antidepressants, disopyramide, quinidine, procainamide) · Meglumine antimoniate may prolong QT interval further with increased risk for arrhythmias
Aminoglycosides · Increased risk of nephrotoxicity · major
NSAIDs · Increased risk of nephrotoxicity · moderate

모니터링

Efficacy (PCR preferred)
CBC (baseline and periodic)
Liver enzymes (baseline and periodic)
Renal function tests (serum creatinine, BUN) (baseline and periodic)
Serum lipase and amylase (baseline and periodic)
Urinalysis (baseline and periodic)
Urinalysis (specifically for proteinuria/UPC ratio)
BUN and Creatinine
Liver enzymes (ALT, AST, ALP)
Complete Blood Count (CBC)
Clinical signs of injection site reactions

과용량

No specific overdose information is available. Depending on the dosage, a single massive overdose could potentially cause **renal, hepatic, pancreatic, and hematologic toxicity**. Clinically, **gastrointestinal effects (severe vomiting)** and **profound lethargy** would be the most likely immediate outcomes. *Management*: Observe the patient closely, provide supportive care (IV fluids to protect renal function), and contact an animal poison control center for further guidance.

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