니타족사니드

항기생충제

**니타족사니드(Nitazoxanide)**는 광범위 티아졸리드계 항기생충제 및 항균제입니다. 주요 임상 특징: * **광범위한 활성** : 다양한 원충(근육포자충, 지아르디아, 와포자충 포함), 선충, 흡충 및 혐기성 세균(예: 헬리코박터 파일로리)에 대해 활성을 나타냅니다. * **말에서의 사용** : 과거 말 원충성 척수뇌염(EPM) 치료용 경구 페이스트(Navigator®)로 FDA 승인을 받았으나, 현재 미국 시장에서는 철수되었습니다. * **소동물에서의 사용** : 개와 고양이의 난치성 와포자충 및 지아르디아 감염에 대한 허가 외 사용(off-label)에 관심이 높습니다. 그러나 소동물(특히 개)에서는 심각한 위장관 부작용으로 인해 임상적 유용성이 제한되는 경우가 많습니다. * **인체에서의 사용** : 와포자충 및 지아르디아로 인한 인체 설사 치료제로 FDA 승인을 받았으며, 일반적으로 내약성이 매우 우수합니다.

작용 기전: **Nitazoxanide** acts as a prodrug and is rapidly converted into its active metabolites, **tizoxanide** and **tizoxanide glucuronide**. * **Mechanism**: It inhibits the **pyruvate:ferredoxin oxidoreductase (PFOR)** enzyme-dependent electron transfer reactions. * **Pathway**: Inhibition of PFOR → disruption of essential anaerobic energy metabolism → death of susceptible protozoa and anaerobic bacteria. * Unlike nitroimidazoles (e.g., metronidazole), nitazoxanide does not appear to cause DNA damage, reducing its mutagenic potential.

동물 종별 용량

Cats

Cryptosporidia-associated diarrhea · 25 mg/kg PO q12-24h · PO · q12-24h · No drug is consistently effective. Diarrhea sometimes resolves after administration.

Horses

Equine protozoal myeloencephalitis (EPM) caused by Sarcocystis neurona · Days 1-5: 25 mg/kg (11.36 mg/lb) PO once daily; Days 6-28: 50 mg/kg (22.72 mg/lb) PO once daily · PO · once daily · 28 days · Product has been withdrawn from the US market.
Relapsing EPM · Extend the treatment regimen from 28 to 56 days · PO · once daily · 56 days · Potentially effective therapy for relapsing cases.

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

투여 경로

금기

Horses less than 1 year of age
Horses that are sick or debilitated for reasons other than EPM
Use with extreme caution in stallions and horses predisposed to laminitis
Animals with compromised renal or hepatic function (safety not established)

이상반응

Horses: Fever, anorexia, lethargy/depression, decreased gut sounds, diarrhea/enterocolitis, colic, laminitis, head/limb edema
Horses: 'Treatment crisis' (CNS inflammation secondary to dying protozoa)
Dogs: Excessive salivation, vomiting, diarrhea (often therapy-limiting)
Humans: Yellow discoloration of sclera (rare, reversible)

약물 상호작용

Highly protein-bound drugs with narrow therapeutic index · Use with caution; tizoxanide is >99% protein bound and may displace or be displaced by other highly bound drugs, potentially altering free drug concentrations.

모니터링

Clinical efficacy (resolution of diarrhea or neurological signs)
Weekly body weight
Adverse reactions (GI upset, hypersalivation)
If adverse reactions occur: Physical exam, CBC, serum albumin, total serum protein

과용량

Information on acute toxicity is limited. * **Horses**: Overdoses of 2.5X have been associated with fatalities. Doses of ~5X labeled dose caused anorexia, diarrhea, and lethargy within 4 days. * **Dogs/Cats**: Oral LD50 is > 10 g/kg. * **Rats**: Repeated doses of 450 mg/kg caused intense salivation and increased liver/spleen weights. * **Humans**: Doses up to 4 grams have been taken without significant adverse effects. > **Treatment**: In the event of an overdose, observe the patient closely and provide supportive care.

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