페닐에프린
Phenylephrine
Phenylephrine Hydrochloride
다른 이름: Neo-Synephrine · AH-chew D · Little Colds Decongestant · Lusonal · Nasop · Sudogest PE · Sudafed PE · Pedia Care Children's Decongestant · Triaminic Thin Strips Cold · Minims Phenylephrine · fenilefrina · phenylephrinum · m-synephrine · Phenylephrine hydrochloride
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| As a CRI to increase peripheral vascular resistance and mean arterial blood pressure | Low dose is 1 microgram/kg/min; high dose is 3 micrograms/kg/min | IV | CRI | — | 🌎 NA |
| As a constant rate infusion for profound vasodilation due to septic shock | 2-10 micrograms/kg/minute | IV | CRI | — | 🌎 NA |
| As a vasopressor in catastrophic stages of hypovolemic shock | 1-3 micrograms/kg/min | IV | CRI | — | 🌎 NA |
| Diagnosis of Horner's syndrome (denervation hypersensitivity) | 1% or 10% solution topically to both eyes | topical | once | single dose | 🌍 EU |
| Hypotension secondary to drugs or vascular failure | Used in conjunction with fluid therapy (exact dose not specified in monograph) | IV | CRI or as directed | Until blood pressure stabilizes | 🌍 EU |
- As a CRI to increase peripheral vascular resistance and mean arterial blood pressure: May see reflex bradycardia, and vasoconstriction can lead to excessive decreases in blood flow to liver, GI tract, and kidneys, although coronary blood flow is increased.
- Diagnosis of Horner's syndrome (denervation hypersensitivity): Time to dilation indicates lesion location: <20 mins = 3rd-order HS; 20-45 mins = 2nd-order HS; 60-90 mins = 1st-order HS or normal. 10% solution causes mydriasis in 5-8 mins in post-ganglionic lesions.
- Hypotension secondary to drugs or vascular failure: Use with caution; raises BP at the expense of vital organ perfusion.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| To increase blood pressure by vasoconstriction in pronounced systemic vasodilation or when increasing myocardial contractility is disadvantageous (e.g., hypertrophic cardiomyopathy) | 1-2 micrograms/kg/minute | IV | CRI | — | 🌎 NA |
| As a constant rate infusion for profound vasodilation due to septic shock | 2-10 micrograms/kg/minute | IV | CRI | — | 🌎 NA |
| As a vasopressor in catastrophic stages of hypovolemic shock | 1-3 micrograms/kg/min | IV | CRI | — | 🌎 NA |
| As a CRI to increase peripheral vascular resistance and mean arterial blood pressure | Low dose is 1 microgram/kg/min; high dose is 3 micrograms/kg/min | IV | CRI | — | 🌎 NA |
| Diagnosis of Horner's syndrome (denervation hypersensitivity) | 1% solution topically to both eyes | topical | once | single dose | 🌍 EU |
- To increase blood pressure by vasoconstriction in pronounced systemic vasodilation or when increasing myocardial contractility is disadvantageous (e.g., hypertrophic cardiomyopathy): Infusions of 1 microgram/kg/min significantly increased mean arterial pressure without a change in cardiac output. At 2 micrograms/kg/min, cardiac index also was increased with an increase in stroke volume index.
- As a CRI to increase peripheral vascular resistance and mean arterial blood pressure: May see reflex bradycardia, and vasoconstriction can lead to excessive decreases in blood flow to liver, GI tract, and kidneys, although coronary blood flow is increased.
- Diagnosis of Horner's syndrome (denervation hypersensitivity): Use lower concentrate solutions in cats to avoid systemic hypertension.
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| General use | 5 mg | IV | Single dose | — | 🌎 NA |
- General use: ARCI UCGFS Class 3 Drug
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
페닐에프린(Phenylephrine)은 강력하고 직접적으로 작용하는 합성 교감신경 흥분 아민으로, 수의학에서는 주로 강력한 혈관 수축 특성 때문에 사용됩니다.
주요 임상 적용 분야는 다음과 같습니다:
- 저혈압 및 쇼크: 적절한 체액 보충 후, 명백한 심장 자극 없이 혈압을 높이기 위해 비경구적으로 사용됩니다.
- 약물 유발성 저혈압: 약물 과다 복용 또는 특이 반응(예: 페노티아진, 아드레날린 차단제)으로 인한 저혈압 위기에 매우 효과적입니다.
- 안과적 사용: 진단용 안과 검사, 후홍채유착 형성 감소, 복합성 포도막염과 관련된 통증 완화를 위해 국소적으로 적용됩니다.
- 코막힘 완화: 점막 충혈을 줄이기 위해 비강 내로 투여됩니다.
임상 팁: 페닐에프린은 정상 용량에서 유의미한 베타-아드레날린 활성이 없기 때문에, 혈압 상승이 필요하지만 심박수나 심근 작업량의 증가가 금기인 경우(예: 비대성 심근병증 환자)에 특히 유용합니다.
작용 기전
Phenylephrine is a highly selective alpha-1 adrenergic receptor agonist.
- Vascular Smooth Muscle: Binds to post-synaptic alpha-1 receptors → activates Gq-proteins → stimulates Phospholipase C (PLC) → cleaves PIP2 into Inositol Triphosphate (IP3) and Diacylglycerol (DAG) → IP3 triggers the release of intracellular calcium from the sarcoplasmic reticulum → profound vasoconstriction.
- Cardiovascular Effects: Intravenous administration causes peripheral vasoconstriction, leading to significant increases in both diastolic and systolic blood pressures. This sudden increase in blood pressure often triggers a baroreceptor-mediated reflex bradycardia (which can be blocked by anticholinergics like atropine).
- Organ Perfusion: Constricts most vascular beds (renal, splanchnic, pulmonary, cutaneous), though coronary blood flow is typically increased due to elevated aortic diastolic pressure.
안전성·주의사항
금기사항
- Severe hypertension
- Ventricular tachycardia
- Hypersensitivity to phenylephrine
- Do not apply topically once ophthalmic surgery has started (to avoid direct arterial absorption)
부작용
- Reflex bradycardia
- CNS effects (excitement, restlessness, headache)
- Arrhythmias (rare)
- Severe extravasation injuries (tissue necrosis and sloughing)
- Hypertension
- Tachycardia
- Tissue necrosis and sloughing (if IV extravasation occurs)
주의
WARNING: Extravasation injuries with phenylephrine can be very serious, leading to necrosis and sloughing of surrounding tissue. IV sites must be routinely monitored. If extravasation occurs, infiltrate the ischemic area with 5-10 mg phentolamine in 10-15 mL of normal saline using a fine needle.
- Extreme Caution: Use carefully in geriatric patients, and those with hyperthyroidism, bradycardia, partial heart block, or other heart disease.
- Not a Substitute for Fluids: Phenylephrine is not a replacement for adequate volume therapy in patients with shock; hypovolemia must be corrected first.
- Pregnancy: FDA Category C. Can cause contraction of the pregnant uterus and constriction of uterine blood vessels. Use with caution.
약물 상호작용
Higher dosages of phenylephrine may be required to attain a pressor effect if these agents have been used prior to therapy.
Potentially may induce cardiac arrhythmias when used with halothane anesthesia.
Block the reflex bradycardia caused by phenylephrine.
The cardiostimulatory effects of phenylephrine (seen at high doses) can be blocked.
Use with phenylephrine may cause increased myocardium sensitization.
Should not be used with phenylephrine because of a pronounced pressor effect.
When used concurrently with oxytocic agents, pressor effects may be enhanced.
Tachycardia and serious arrhythmias are possible.
Increased risk of cardiac arrhythmias
Enhanced pressor effects leading to severe hypertension
모니터링
- Cardiac rate and rhythm
- Blood gases (if possible)
- IV catheter site (for signs of extravasation)
- Blood pressure (systemic use or high-concentration topical use)
- Heart rate and rhythm (ECG)
- Pupillary response and time to dilation (for Horner's syndrome testing)
약동학
반감기
흡수
After oral administration, phenylephrine is rapidly metabolized in the GI tract and cardiovascular effects are generally unattainable via this route. Following IV administration, pressor effects begin almost immediately and persist for up to 20 minutes. IM onset is 10-15 minutes, lasting approximately one hour.
분포
It is unknown if phenylephrine is excreted into milk.
대사
Metabolized by the liver.
배설
The effects of the drug are terminated by uptake into tissues.
과다투여
The margin of safety with phenylephrine overdose is fairly wide, especially after oral administration.
Clinical Signs:
- Common findings in dogs include vomiting, lethargy, depression, hyperactivity, and tachycardia.
- Severe overdosage can cause hypertension, seizures, paresthesias, ventricular extrasystoles, and cerebral hemorrhage.
Treatment:
- Vomiting is commonly seen and may self-decontaminate oral exposures.
- Cardiovascular changes often respond well to IV fluids.
- Beta-blockers or nitroprusside may be indicated when signs (tachycardia, severe hypertension) are refractory to fluids.
제품
제형
- Injection
- Oral tablets
- Oral solution/liquid
- Oral strips
- Ophthalmic drops
- Intranasal sprays
- Injectable: 1% (10 mg/ml) solution
- Ophthalmic: 2.5% solution (single-dose vials)
- Ophthalmic: 10% solution (single-dose vials)
동물용의약품
- Oral combination products marketed as 'cough' syrups containing phenylephrine, pyrilamine, guaifenesin, sodium citrate, and sometimes ammonium chloride.
- Phenylephrine 1% injectable solution
- Phenylephrine 2.5% ophthalmic solution
- Phenylephrine 10% ophthalmic solution
인용의약품
- Phenylephrine HCl Oral Tablets: 10 mg (regular & chewable)
- Phenylephrine HCl Oral Solution/Liquid: 2.5 mg/mL (concentrate), 2.5 mg/5mL & 7.5 mg/5 mL
- Phenylephrine HCl Oral Strips: 2.5 mg
- Phenylephrine HCl Injection: 1% (10 mg/mL) in 1 mL & 5 mL vials and 1 mL Uni-Nest amps
- Ophthalmic and intranasal dosage forms
- Minims Phenylephrine Hydrochloride 2.5% and 10% eye drops
규제 현황
POM (Prescription Only Medicine)
POM-V or POM depending on specific formulation.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
The injectable product should be stored protected from light. Do not use solutions if they are brown or contain a precipitate. Oxidation of the drug can occur without a color change. Commercially available ampules have air replaced with nitrogen and a sulfite added to protect against oxidation.
보호자 정보
- 병원 내 사용: 주사용 페닐에프린은 강력한 심혈관계 약물로, 지속적인 혈압 및 심전도 모니터링이 가능한 임상 환경에서 수의학 전문가에 의해서만 사용되어야 합니다.
- 경구용 제품: 페닐에프린이 포함된 일반의약품(사람용 감기약)은 수의사의 명확한 지시 없이 반려동물에게 절대 투여해서는 안 됩니다. 이러한 약물에는 종종 다른 독성 성분(예: 아세트아미노펜 또는 울혈제거제)이 포함되어 있어 구토, 과잉 행동 또는 심박수 이상을 유발할 수 있습니다.
- 우발적 섭취: 반려동물이 페닐에프린이 포함된 제품을 우발적으로 섭취한 경우, 즉시 수의사나 동물 독극물 관리 센터에 연락하십시오.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.