날록손

해독제; 오피오이드 길항제

**날록손(Naloxone)**은 순수 오피오이드 길항제로, 수의학에서는 주로 오피오이드 작용제의 효과(호흡 억제, 진정, 불쾌감 등)를 역전시키는 데 사용됩니다. 오피오이드 과다 복용 시 생명을 구하는 해독제입니다. 주요 용도 외에도 다양한 형태의 쇼크(패혈성, 저혈량성, 심인성) 치료 및 내인성 엔돌핀을 차단하여 꼬리 쫓기와 같은 자해 행동을 억제하는 데 대한 연구가 진행 중입니다. **임상 요점:** 날록손 자체에는 진통 효과가 없습니다. 오피오이드로 인한 호흡 억제를 역전시키는 데 사용될 때 오피오이드의 진통 효과도 동시에 역전시키므로 갑작스러운 통증 재발과 카테콜아민 방출을 유발할 수 있습니다.

작용 기전: Naloxone acts as a competitive antagonist at opioid receptors. It binds primarily to the **mu (μ)** receptor, but also has affinity for **kappa (κ)** and **sigma (σ)** receptors. By occupying these receptors without activating them, it displaces opioid agonists → **rapid reversal of opioid-induced respiratory and CNS depression**. At very high doses, naloxone may exhibit additional pharmacologic activity, including **GABA antagonism** and the ability to increase dopamine levels.

동물 종별 용량

Cats

Opioid reversal · 0.01-0.02 mg/kg · IM, IV, or SC · As needed
Neonatal opioid reversal (following caesarian sections) · 1 drop of naloxone (0.4 mg/mL from a 1-mL syringe) · Sublingual · As needed · Administered under the tongue.
Adjunctive treatment of hyperthermia · 0.01 mg/kg · IM or SC · Once · Used in cats with body temperatures exceeding 41.1°C (106°F) following anesthesia; temperature returned to normal in <30 minutes.
Opioid overdose / reversal · 0.01-0.02 mg/kg · IV · prn · Short duration (30-40 min) · Repeated doses may be required for longer-acting opioids.
Opioid overdose / reversal · 0.04 mg/kg · IM/SC/intratracheal · prn · Short duration
Prolonged opioid antagonism · 0.02 mg/kg/h · IV · CRI · As needed · Administered as a continuous rate infusion if a longer duration of opioid antagonism is required.

Horses

Opioid reversal · 0.01-0.022 mg/kg · IV · As needed · To reverse sedative and excitatory effects of narcotic agonists. Note: ARCI UCGFS Class 3 Drug.
Limit increases in locomotor activity secondary to narcotic agonists · 0.01 mg/kg · IV · As needed
Treatment of opioid gastrointestinal tract dysfunction · 10-50 micrograms/kg · IV · As needed · Will induce movement and passage of contents.

SmallMammals

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

투여 경로

IVIMSCSublingualIntratracheal

금기

Hypersensitivity to naloxone
Indiscriminate use in animals that have undergone major surgery or trauma (due to severe pain from analgesia reversal)

이상반응

Reversal of analgesia (return of pain)
Acute withdrawal syndrome in opioid-dependent patients
CNS excitement (especially if used in meperidine overdose)
Seizures (at very high doses, likely secondary to GABA antagonism)
Acute severe discomfort or pain (due to sudden loss of analgesia)
Antanalgesic effects in opioid-naïve subjects
Transient elevation of unconsciousness (at low doses)

약물 상호작용

Opioid partial-agonists (butorphanol, pentazocine, nalbuphine) · Naloxone may antagonize the effects of these agents (respiratory depression, analgesia). It should not be relied upon to treat respiratory depression caused by buprenorphine.
Clonidine · Naloxone may reduce the hypotensive and bradycardic effects of clonidine; potentially useful for clonidine overdoses.
Yohimbine · Naloxone may increase the CNS effects of yohimbine (anxiety, tremors, nausea, palpitations) and increase plasma cortisol levels.
Opioid Agonists (e.g., Morphine, Methadone, Fentanyl) · Naloxone reverses the analgesic, sedative, and respiratory depressant effects of opioid agonists. · major
Buprenorphine · Buprenorphine binds tightly to opioid receptors; naloxone may not fully reverse its effects or may require much higher doses. · moderate

모니터링

Respiratory rate and depth
CNS function (level of sedation/arousal)
Pain associated with opiate reversal
Respiratory rate and effort
Level of consciousness / sedation score
Pain score (monitor for acute pain upon reversal)
Heart rate and blood pressure

과용량

Naloxone is considered a very safe agent with a very wide margin of safety. However, massive overdoses have initiated seizures in a few patients, which is theorized to be secondary to GABA antagonism.

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