프로카바진

항종양제 - 알킬화제

**프로카바진(Procarbazine)**은 비정형 알킬화 항종양제로, 수의학에서는 주로 개와 고양이의 재발성 또는 난치성 림프종 치료를 위한 **MOPP** 또는 **LOPP** 화학요법 프로토콜의 일부로 사용됩니다. > **임상 요점**: 다른 많은 항암제와 달리 프로카바진은 지용성이 높아 **혈액뇌장벽(BBB)**을 쉽게 통과합니다. 이러한 독특한 특성 덕분에 중추신경계(CNS) 종양 및 염증성 질환, 특히 개의 **육아종성 수막뇌염(GME)** 치료에 매우 효과적입니다. 또한 프로카바진은 약한 **모노아민 산화효소 억제(MAOI)** 작용을 하므로 고혈압 위기를 예방하기 위해 다른 약물(예: 삼환계 항우울제, 교감신경 흥분제)이나 특정 음식(티라민이 풍부한 음식)과의 병용 시 각별한 주의가 필요합니다.

작용 기전: Procarbazine is a prodrug that requires hepatic and renal metabolism to become active. Its exact mechanism is complex and multifaceted: - **Hepatic Metabolism** → Procarbazine is oxidized to **azo-procarbazine** and further metabolized to yield **methyl radicals** and **hydrogen peroxide**. - **DNA Alkylation** → The methyl radicals directly methylate nucleic acids, causing DNA strand breakage and inhibiting the synthesis of DNA, RNA, and proteins. - **Oxidative Stress** → The auto-oxidation process generates hydrogen peroxide, which directly induces oxidative damage to DNA. - **MAO Inhibition** → As an off-target effect, it inhibits the enzyme **monoamine oxidase (MAO)**, preventing the breakdown of monoamines like serotonin, norepinephrine, and dopamine.

동물 종별 용량

Cats

MOPP lymphoma rescue · 50 mg/m2 or 10 mg (total dose per cat) · PO · once daily for the first 14 days of the treatment cycle · 14 days · Used as part of a protocol in combination with other antineoplastic agents.

Dogs

Lymphoma rescue (MOPP protocol) · 50 mg/m2 · PO · once daily for the first 14 days of the treatment cycle · 14 days · Used as part of a protocol in combination with other antineoplastic agents.
Granulomatous meningoencephalitis (GME) · 25-50 mg/m2 · PO · once daily initially, then every other day · Initially given with prednisone treatment. After the first month, attempt to reduce to every other day. Monitor CBC weekly for the first month.

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

투여 경로

금기

Known hypersensitivity to procarbazine
Inadequate bone marrow reserve

이상반응

Nausea and vomiting
Hepatotoxicity
Myelosuppression (thrombocytopenia, leukopenia)
Hemorrhagic gastritis
CNS effects (sedation, agitation)
Peripheral neuropathy (loss of tendon reflexes, paresthesias, myalgia)

약물 상호작용

Alcohol/Ethanol · May cause severe nausea and vomiting (disulfiram-like reaction).
CNS Depressant Drugs (barbiturates, opiates, antihistamines, phenothiazines) · Procarbazine can cause CNS depression; concurrent use can lead to severe depression. Coma and death have been reported with opiates.
Foods with high tyramine content (aged cheese, yogurt) · Serious hypertension may result due to procarbazine's MAOI activity.
Sympathomimetics (phenylpropanolamine, etc.) · Serious hypertension may result due to procarbazine's MAOI activity.
Tricyclic Antidepressants (clomipramine, amitriptyline) · Do not use concurrently due to MAOI activity; risk of serotonin syndrome or hypertensive crisis.

모니터링

Baseline: CBC, hepatic and renal function, urinalysis
Repeat CBC at least once weekly for the first month of treatment, and then monthly thereafter
Monitor for signs of neurotoxicity or severe GI distress

과용량

The LD50 for laboratory animals ranges from 150 mg/kg (rabbits) to 1.3 grams/kg (mice). - **Treatment**: Treat overdoses aggressively to remove the drug from the gut if the overdose occurred within an hour or two (e.g., induction of emesis, activated charcoal). - **Anticipated Effects**: Extensions of the drug's adverse effect profile, including severe GI distress, profound bone marrow suppression, and CNS effects. - **Management**: Monitor closely and provide supportive care as necessary. 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.