프레가발린
프레가발린은 가바펜틴과 유사한 GABA의 구조적 유사체로, 수의학에서는 주로 **항경련제** 및 **신경병증성 통증 진통제**로 사용됩니다。 * **주요 용도**: 난치성 또는 복합 부분 발작의 보조 요법 및 만성/신경병증성 통증 관리。 * **임상적 특징**: 가바펜틴보다 3~10배 더 강력한 것으로 간주되어 투여 용량을 줄일 수 있으므로 소형 환자에게 유리합니다。 * **안전성**: 일반적으로 내약성이 좋으나, 진정 및 운동 실조가 가장 흔한 용량 의존적 부작용입니다. 개와 고양이에서의 안전성 및 효능에 대한 정보는 현재 제한적이나 점차 증가하고 있습니다。
작용 기전: Pregabalin is a structural analog of the inhibitory neurotransmitter **gamma-aminobutyric acid (GABA)**. Despite its structure, it does not bind directly to GABA receptors. * Binds with high affinity to the **alpha-2-delta (α2δ) subunit** of **voltage-gated calcium channels (CaV)** in the central nervous system. * Binding → Decreased calcium influx at nerve terminals → Inhibition of the release of excitatory neurotransmitters (e.g., **glutamate**, **substance P**, **norepinephrine**). * This reduction in excitatory neurotransmission produces its **analgesic**, **anticonvulsant**, and **anxiolytic** effects.
동물 종별 용량
- Seizure disorders (anecdotal) · 1-2 mg/kg PO q12h · PO · q12h · Most commonly mentioned anecdotal dose.
- Seizure disorders (PK theory) · 1-2 mg/kg PO twice daily · PO · q12h · Theorized reasonable starting dose based on single-dose PK study.
- Neuropathic pain and seizures (extrapolated from PK study) · 4 mg/kg PO twice daily · PO · q12h · Would produce plasma levels within the extrapolated therapeutic range.
- Seizure disorders · 3-4 mg/kg PO every 8 hours · PO · q8h · To minimize side effects, initially start on 2 mg/kg and increase by 1 mg/kg each week until target dose is reached.
- Seizure disorders · gradually increased from 2 mg/kg PO to 3-4 mg/kg q8-12h · PO · q8-12h · Gradual increase needed to minimize sedation.
- Refractory seizures (adjunct therapy) · 2 mg/kg q8-12h, increasing 1 mg/kg/dose each week to a total of 3-4 mg/kg · PO · q8-12h · Used as a third anticonvulsant if control cannot be obtained with phenobarbital and bromides.
용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.
투여 경로
금기
- Hypersensitivity to pregabalin
- Pregnant animals (toxicity demonstrated in experimental studies)
- Abrupt discontinuation
이상반응
- Sedation
- Ataxia
- Somnolence
- Dizziness
- Difficulty with concentration/attention/memory
- Blurred vision
- Dry mouth
- Peripheral edema
- Constipation
- Weight gain
- Syncope
- Congestive heart failure
- Renal failure (reversible)
- Rhabdomyolysis
- Hypersensitivity reactions (angioedema, rash, blisters, wheezing)
- Decreased platelet production
- Increased creatine kinase
약물 상호작용
- ACE Inhibitors (e.g., benazepril, enalapril) · In humans, coadministration may increase risks of edema and hives.
- CNS Depressants · May cause additive CNS depression.
- NSAIDs (e.g., ketorolac, naproxen) · In humans, cited as possibly reducing anticonvulsant effectiveness, though substantive evidence is weak.
모니터링
- Efficacy (seizure frequency, pain scores)
- Adverse effects (sedation, ataxia)
- Seizure frequency and severity
- Pain scores
- Renal function (BUN, creatinine, USG)
- Hepatic enzyme activities (during prolonged therapy)
과용량
There is limited experience with overdoses of pregabalin in veterinary medicine. One human ingested 8 grams without significant effect. There is no specific antidote for overdose. Standard decontamination protocols can be employed if indicated. Contact an animal poison center for more information.
VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.