페닐프로판올아민
페닐프로판올아민(PPA)은 비선택적 교감신경 흥분성 아민으로, 수의학에서는 주로 중성화된 암컷 개에서 발생하는 **요도 괄약근 기능 부전(USMI)**과 관련된 **요실금**을 관리하는 데 사용됩니다. 과거에는 코막힘 완화제로 사용되기도 했으나, 수의학적 주요 적응증은 방광경부와 근위 요도의 평활근 긴장도를 증가시키는 능력에 기반합니다. **임상 요점:** * PPA는 반려견의 후천성 요실금에 매우 효과적이며, 성공률은 종종 75-85%를 초과합니다. * 교감신경 흥분제이므로 전신적인 아드레날린성 부작용, 특히 고혈압 및 행동 변화(불안, 초조)를 유발할 수 있습니다. * 미국에서는 메스암페타민 합성의 전구체로 사용될 가능성 때문에 제1종 화학물질로 분류되어 있어 구매 시 특정 제한을 받을 수 있습니다.
작용 기전: Phenylpropanolamine acts primarily as an **indirect-acting sympathomimetic**, though it may have some direct receptor agonist activity. * **Mechanism:** It stimulates the release of endogenous **norepinephrine** from presynaptic nerve terminals. * **Pathway:** Released norepinephrine binds to **alpha-1 adrenergic receptors** located in the smooth muscle of the internal urethral sphincter and bladder neck → **increased sphincter tone** → prevention of urine leakage. * It also stimulates beta-adrenergic receptors, which can contribute to systemic cardiovascular effects (e.g., increased heart rate and contractility). * **Note:** Prolonged use or excessive dosing frequency can theoretically deplete norepinephrine from storage sites, leading to tachyphylaxis (decreased response), though this is rarely documented in dogs or cats treated for incontinence.
동물 종별 용량
- Urethral sphincter hypotonus · 12.5 mg PO q8h · PO · q8h
- Urethral sphincter hypotonus · 1-1.5 mg/kg PO q8h · PO · q8h
- Urethral sphincter hypotonus · 1.1 -2.2 mg/kg PO two to three times daily · PO · q8-12h
- Urethral sphincter hypotonus · 12.5-50 mg (total dose) or 1-2 mg/kg PO q8h · PO · q8h
- Urethral sphincter hypotonus · Dogs weighing less than 40 lbs: ½ capsule PO daily. Dogs 40-100 lbs: 1 capsule PO daily. Dogs weighing >100 lbs: 1.5 capsules PO per day. · PO · q24h · Using the time-release 75 mg capsules
- Urethral sphincter hypotonus · 1-1.5 mg/kg PO two to three times a day · PO · q8-12h · Controls 74-92% of dogs with primary sphincter mechanism incontinence. Over half of dogs not responding to regular PPA will respond to sustained-release PPA.
- Urethral sphincter hypotonus · 5-50 mg per dog PO q8h or 1.5 mg/kg PO q8h-12h · PO · q8-12h
- Retrograde ejaculation · 3-4 mg/kg PO twice daily · PO · q12h · May be tried
용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.
투여 경로
금기
- Glaucoma
- Prostatic hypertrophy
- Hyperthyroidism
- Diabetes mellitus
- Cardiovascular disorders
- Hypertension
- Severe renal or hepatic disease
이상반응
- Restlessness
- Anxiety
- Irritability
- Urine retention
- Tachycardia
- Hypertension
- Anorexia
- Rare reports of 'stroke' in dogs
- Panting
약물 상호작용
- Halothane · Increased risk of arrhythmias. Propranolol may be administered should these occur. · major
- Monoamine Oxidase (MAO) Inhibitors (e.g., amitraz, selegiline) · Should not be given within two weeks of receiving MAOIs due to risk of severe hypertension and toxicity.
- NSAIDs (including aspirin) · Increased chance of hypertension if given concomitantly.
- Reserpine · Increased chance of hypertension if given concomitantly.
- Other Sympathomimetic Agents (e.g., ephedrine) · Should not be administered together as increased toxicity may result.
- Tricyclic Antidepressants (e.g., clomipramine, amitriptyline) · Increased chance of hypertension if given concomitantly.
- NSAIDs · Increased risk of hypertension · moderate
- Monoamine Oxidase Inhibitors (MAOIs) · Risk of severe hypertensive crisis · major
- Tricyclic Antidepressants · Increased sympathomimetic effects and risk of hypertension · major
모니터링
- Clinical effectiveness (reduction in urine leakage)
- Adverse effects (restlessness, irritability, anorexia)
- Blood pressure
- Clinical response (reduction in urinary incontinence)
- Heart rate and rhythm
- Behavioral changes (restlessness, pacing)
과용량
Clinical signs of overdosage may consist of an exacerbation of adverse effects (restlessness, anxiety). **Severe Overdose Signs:** * **Cardiovascular:** Hypertension to rebound hypotension, bradycardias to tachycardias, and cardiovascular collapse. * **CNS:** Stimulation progressing to coma. * *Case report:* A dog ingesting 48 mg/kg developed ventricular tachycardia and myocardial necrosis (resolved within 6 months). **Treatment:** * If recent, empty the stomach using usual precautions and administer charcoal and a cathartic. * Treat clinical signs supportively. * > **WARNING:** Do NOT use propranolol to treat hypertension in bradycardic patients. Do NOT use atropine to treat bradycardia. * Hypertension may be managed with a phenothiazine (e.g., acepromazine at very low doses such as 0.02 mg/kg IV or IM). If unsuccessful, consider a CRI of nitroprusside. * Contact an animal poison control center for further guidance.
VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.