๋ชฌํ ๋ฃจ์นด์คํธ ๋ํธ๋ฅจ
**๋ชฌํ ๋ฃจ์นด์คํธ ๋ํธ๋ฅจ(Montelukast sodium)**์ ๋ฅ์ฝํธ๋ฆฌ์ ์์ฉ์ฒด ๊ธธํญ์ ์ ๋๋ค. ์์ํ์์๋ ์ฃผ๋ก **๊ณ ์์ด**์ ๋ค์๊ณผ ๊ฐ์ ์ผ์ฆ์ฑ ์งํ์ ์คํ๋ผ๋ฒจ๋ก ์ฌ์ฉ๋ฉ๋๋ค: * **๊ณ ์์ด ์ฒ์** * **์ผ์ฆ์ฑ ์ฅ์งํ(IBD)** * ๋ง์ฑ ์๊ธฐ๋ ๊ฐ์ผ * **์ฌ์ฅ์ฌ์์ถฉ ์ฐ๊ด ํธํก๊ธฐ ์งํ(HARD)** > **์์ ํ:** ์ผ์ฆ ๋งค๊ฐ์ฒด๋ฅผ ์ฐจ๋จํ์ฌ ๊ณ ์์ด ์ฒ์์ ์ด๋ก ์ ์ผ๋ก ์ ๋งํ์ง๋ง, ์์์ ํจ๋ฅ์ ๋์ฒด๋ก ์ค๋ง์ค๋ฌ์ด ํธ์ ๋๋ค. ์ผ๋ฐ์ ์ผ๋ก 1์ฐจ ์น๋ฃ์ ๋ณด๋ค๋ 2์ฐจ ๋๋ 3์ฐจ ๋ณด์กฐ ์๋ฒ์ผ๋ก ๊ฐ์ฃผ๋ฉ๋๋ค. ์ฌ๋ฐ์ฑ ๊ธฐ๋ ํ์(RAO)๊ฐ ์๋ ๋ง์ ๋์์ผ๋ก ํ ์๊ท๋ชจ ์ํ์์๋ ํจ๋ฅ์ ์ ์ฆํ์ง ๋ชปํ์ต๋๋ค. ์ธ์ฒด ์ํ์์๋ ์๋ ๋ฅด๊ธฐ์ฑ ๋น์ผ ๋ฐ ์ฒ์ ์น๋ฃ์ ๋ก FDA ์น์ธ์ ๋ฐ์์ต๋๋ค.
์์ฉ ๊ธฐ์ : Montelukast acts as a highly selective and competitive **cysteinyl leukotriene receptor (CysLT1) antagonist**. * Arachidonic acid โ 5-lipoxygenase pathway โ **Cysteinyl leukotrienes (LTC4, LTD4, LTE4)**. * These leukotrienes are potent inflammatory mediators released by **mast cells** and **eosinophils**. * By blocking the **CysLT1 receptor** in the airways and gastrointestinal tract, montelukast prevents leukotriene-mediated bronchoconstriction, mucosal edema, vascular permeability, and eosinophil recruitment.
๋๋ฌผ ์ข ๋ณ ์ฉ๋
- Feline asthma ยท 0.5-1 mg/kg PO once daily (q24h) ยท PO ยท q24h ยท Anecdotal reports of efficacy; more conclusive evidence is needed before regular use.
- Adjunctive treatment of the chronic 'snuffler' ยท 0.25-0.5 mg/kg PO q24h ยท PO ยท q24h ยท i.e., 1/8th of a 10 mg Singulair tablet.
- Inflammatory Bowel Disease (IBD) ยท 0.5-1 mg/kg PO once daily ยท PO ยท q24h ยท For mild cases involving eosinophils and lymphocytes. May be used in combination with other drugs.
- Adjunctive treatment of feline heartworm ยท 2 mg total dose (PO) once daily ยท PO ยท q24h ยท Anecdotal evidence suggests it may help thwart acute, fatal lung injury when an adult worm dies.
์ฉ๋์ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์ฐธ๊ณ ์๋ฃ์ ๋๋ค. ํญ์ ์ต์ ๋ผ๋ฒจ๊ณผ ๊ฐ๋ณ ํ์์ ๋ํด ํ์ธํ์ญ์์ค.
ํฌ์ฌ ๊ฒฝ๋ก
๊ธ๊ธฐ
- Hypersensitivity to montelukast or any component of the product
- Not for use in reversing acute bronchospasm (asthma attacks)
์ด์๋ฐ์
- No significant adverse effects reported in cats to date
- Humans (rare): behavioral effects (aggression, suicidal thoughts), palpitations, cholestatic hepatitis, allergic granulomatous angiitis
์ฝ๋ฌผ ์ํธ์์ฉ
- Phenobarbital ยท CYP-450 enzyme inducer; may reduce montelukast plasma concentrations and efficacy.
- Rifampin ยท CYP-450 enzyme inducer; may reduce montelukast plasma concentrations and efficacy.
- Prednisone / Prednisolone ยท Severe peripheral edema has been reported in a human receiving both drugs, presumably due to increased renal tubular sodium and fluid retention. Clinical significance in veterinary patients is unclear.
๋ชจ๋ํฐ๋ง
- Clinical efficacy (improvement in respiratory or GI signs)
๊ณผ์ฉ๋
**Overdose Toxicity:** Montelukast is relatively safe in overdose situations. * **Animal Data:** Rats and mice survived oral doses of approximately 230X to 335X the usual human adult dose. * **Human Data:** Doses as high as 1,000 mg have been reported with the majority having no adverse effects. * **Clinical Signs (if present):** Headache, vomiting, psychomotor hyperactivity, thirst, somnolence, mydriasis, hyperkinesia, and abdominal pain. * **Treatment:** Basically supportive. No specific antidote is known.
VetSheet ์ฝ๋ฌผ ๋ ํผ๋ฐ์ค๋ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์์ฌ๊ฒฐ์ ๋ณด์กฐ ๋๊ตฌ์ด๋ฉฐ, ์ ๋ฌธ์ ํ๋จ์ด๋ ์ ์กฐ์ฌ์ ์ต์ ๋ผ๋ฒจ์ ๋์ ํ์ง ์์ต๋๋ค.