옥시모르폰

오피오이드 작용제

옥시모르폰은 강력한 반합성 **오피오이드 작용제**로, 수의학에서 주로 진정/보정제, 진통제 및 마취 전 투약으로 사용됩니다. * **효력:** 무게 기준으로 모르핀보다 약 10배 더 강력합니다。 * **심혈관계 효과:** 심혈관계에 미치는 영향은 일반적으로 임상적으로 유의하지 않아 심혈관 질환 환자에게 비교적 안전한 선택입니다。 * **히스타민 방출:** 모르핀이나 메페리딘과 달리 정맥 투여 시 유의미한 히스타민 방출을 일으키지 않는 것으로 보입니다。 * **임상 요점:** 남용 가능성이 높아 스케줄 II(C-II) 통제 물질로 분류됩니다. 중등도에서 중증 통증에 매우 효과적이지만, 수의 임상에서는 접근성과 비용이 제한 요소가 될 수 있습니다。

작용 기전: Oxymorphone acts primarily as a full agonist at **mu (μ) opioid receptors**, with some possible activity at **delta (δ) receptors**. * **Pathway:** Binds to G-protein coupled mu-opioid receptors in the CNS (limbic system, spinal cord, thalamus, midbrain) and peripheral tissues (GI tract, urinary tract) → inhibits adenylate cyclase → decreases intracellular cAMP → promotes opening of potassium channels and inhibits voltage-gated calcium channels → hyperpolarizes nociceptive neurons and inhibits the release of pain neurotransmitters (e.g., Substance P). * **Effects:** This results in profound analgesia, sedation, respiratory depression, and altered GI motility.

동물 종별 용량

Cats

As a preanesthetic/analgesic · 0.05-0.1 mg/kg IM · IM · Once · may cause dysphoria or excitement, add sedative.
As an analgesic (acute pain) · 0.05-0.1 mg/kg IM, SC or IV · IM/SC/IV · q1-3h · concomitant tranquilization recommended
As an analgesic (acute pain) for animals with cardiovascular disease · 0.05-0.1 mg/kg IV, IM or SC · IV/IM/SC · q2-4h
As an analgesic (acute pain) · 0.025-0.1 mg/kg IV (IM or SC) · IV/IM/SC · q2-6h
As an analgesic (acute pain) · 0.02-0.1 mg/kg IV, IM, or SC · IV/IM/SC · q3-4h

Ferrets

Analgesia · 0.05-0.2 mg/kg IV or IM · IV/IM · 2-4 times daily
Analgesia · 0.05-0.2 mg/kg SQ or IM · SQ/IM · q8-12 hrs

Horses

As an analgesic · 0.01-0.02 mg/kg IV · IV · Once
As an analgesic · 0.01-0.022 mg/kg IV ; up to 15 mg total · IV · Once · divide dose into 3-4 increments and give several minutes apart
As an analgesic · 0.02-0.03 mg/kg IM · IM · Once

투여 경로

IVIMSCEpiduralRectalPO

금기

Hypersensitivity to narcotic analgesics
Patients receiving monoamine oxidase inhibitors (MAOIs)
Diarrhea caused by a toxic ingestion (until toxin is eliminated)
Scorpion stings (Centruroides sculpturatus and C. gertschi)

이상반응

Respiratory depression
Bradycardia
Decreased GI motility (constipation)
Panting (commonly seen in dogs)
Ataxia, hyperesthesia, and behavioral changes (cats at high dosages)
CNS excitement (horses)

약물 상호작용

Butorphanol, Buprenorphine, Nalbuphine · Potentially could antagonize opiate effects
CNS Depressants · Additive CNS effects possible
Diuretics · Opiates may decrease efficacy in CHF patients
Monoamine Oxidase Inhibitors (MAOIs) · Extreme caution; may cause signs of opiate overdose
Muscle Relaxants, Skeletal · Oxymorphone may enhance effects
Phenothiazines · May antagonize analgesic effects and increase risk for hypotension
Tricyclic Antidepressants · Oxymorphone may exacerbate the effects of tricyclic antidepressants
Warfarin · Opiates may potentiate anticoagulant activity

모니터링

Respiratory rate/depth
CNS level of depression/excitation
Blood pressure (especially with IV use)
Analgesic activity
Cardiac rate

과용량

Massive overdoses may produce profound respiratory and/or CNS depression in most species. Other effects may include cardiovascular collapse, hypothermia, and skeletal muscle hypotonia. * **Antidote:** **Naloxone** is the agent of choice in treating respiratory depression. * **Management:** In massive overdoses, naloxone doses may need to be repeated. Animals should be closely observed as naloxone's effects sometimes diminish before sub-toxic levels of oxymorphone are attained. Mechanical respiratory support should be considered in cases of severe respiratory depression.

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