페르골리드

도파민 작용제

페르골리드는 맥각 유도체 도파민 작용제로, 수의학에서는 주로 말의 **뇌하수체 중엽 기능 장애(PPID, 일명 말 쿠싱 증후군)** 치료를 위한 **표준 치료제(Gold standard)**로 사용됩니다. * **임상적 중요성**: 다모증(털갈이 지연/긴 털), 무기력, 근육 위축, 제엽염 등 말의 PPID 임상 증상을 관리하는 데 가장 효과적인 약물 요법입니다. * **구입 방법**: 인체용 약물은 심장 판막 질환 위험으로 인해 2007년 미국 시장에서 철수되었으므로, 현재 수의학용으로는 조제 약국(compounding pharmacy)을 통해서만 독점적으로 구할 수 있습니다. * **내약성**: 말에게 일반적으로 매우 내약성이 좋으나, 치료 초기에는 일시적인 식욕 부진이 발생할 수 있습니다.

작용 기전: Pergolide acts as a potent, long-acting agonist at **D1 and D2 dopamine receptors** (estimated to be 10-1000 times more potent than bromocriptine). * **Mechanism in PPID:** In healthy horses, the hypothalamus releases dopamine, which tonically inhibits the pituitary pars intermedia. In horses with PPID, there is a neurodegenerative loss of these dopaminergic neurons. * **Pathway:** Pergolide replaces this lost dopamine tone → binds to **D2 receptors** on melanotropes in the pars intermedia → inhibits the hypersecretion of **pro-opiomelanocortin (POMC)** peptides (including ACTH, α-MSH, and CLIP). * This reduction in POMC peptides normalizes endocrine function and alleviates the clinical signs associated with PPID.

동물 종별 용량

Horses

Equine 'Cushing's-like' Disease [pituitary pars intermedia dysfunction (PPID)] · Initial dose of 1 mg (total dose) per day for horses and ponies with PPID. If the horse owner is willing to administer half the dose twice daily, this may be preferable on the basis of recent pharmacokinetic data. If anorexia or temporary dullness develop, treatment should be halted for 2 days or until appetite improves, and then restarted at 0.25 mg per day for 2 days, 0.5 mg per day for 2 days, and 0.75 mg per day for 2 days. · PO · q24h or divided q12h
Equine 'Cushing's-like' Disease [pituitary pars intermedia dysfunction (PPID)] · 1.7-5.5 micrograms/kg · PO · Varies · Dose varies considerably. The higher doses are used in the more advanced cases or those refractory to treatment at a lower dose.
Equine 'Cushing's-like' Disease [pituitary pars intermedia dysfunction (PPID)] · 0.002 mg/kg. If no improvement is noted within 8-12 weeks, the daily dose can be increased by 0.002 mg/kg monthly up to a total dose of 0.006 mg/kg (3 mg/day for a 500 kg horse). If only a limited response is observed with 0.006 mg/kg dose, addition of cyproheptadine (0.5 mg/kg PO q12h) to pergolide therapy is recommended. · PO · q24h · Usually, only transient anorexia is recognized during the initial week of treatment and can be overcome in time or by cutting the dose in half for 2-4 days.

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

투여 경로

금기

Hypersensitivity to pergolide or other ergot derivatives

이상반응

Anorexia/decreased appetite (up to 10% of horses during the first week)
Colic (rare)
Diarrhea (rare)
Lethargy (dogs)
Vomiting (dogs)
Hypertension (dogs)
Ptosis (dogs)

약물 상호작용

Dopamine antagonists (e.g., phenothiazines) · May decrease the effects of pergolide
Metoclopramide · May decrease the effects of pergolide

모니터링

Dexamethasone suppression test (baseline and at 4-8 weeks post pergolide therapy initiation, repeat in 4-8 weeks if dosage is adjusted)
Blood glucose (baseline, and if abnormal repeat as per dexamethasone suppression test)
Clinical signs (hair coat, weight, PU/PD, etc.)
Periodic CBC and clinical chemistry panel

과용량

Limited information is available on pergolide overdoses. * **Potential effects:** GI disturbances, CNS effects, seizures, and hypotension. * **Dogs:** Accidental ingestion has resulted in vomiting, lethargy, hypertension, and ptosis. * **Treatment:** Care is primarily supportive. Phenothiazines (dopamine antagonists) may be used to decrease CNS stimulation effects.

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