ํ๋กํด๋ก๋ฅดํ๋ผ์ง
ํ๋กํด๋ก๋ฅดํ๋ผ์ง์ ๊ฐ๋ ฅํ **ํ๋ ธํฐ์์ง๊ณ ํญ๊ตฌํ ์ **๋ก, ์์ํ์์๋ ์ฃผ๋ก ๊ฐ์ ๊ณ ์์ด์ ์ฌํ ๋ฉ์ค๊บผ์๊ณผ ๊ตฌํ ๋ฅผ ์กฐ์ ํ๋ ๋ฐ ์ฌ์ฉ๋ฉ๋๋ค. ๊ณผ๊ฑฐ์๋ ์์์ฉ ๋ณตํฉ์ (ํญ์ฝ๋ฆฐ์ ๊ฐ ํฌํจ๋ Darbazineยฎ ๋ฑ)๋ก ๋๋ฆฌ ์ฌ์ฉ๋์์ผ๋, ํ์ฌ๋ ์ธ์ฒด์ฉ ์ ์ ๋ฅผ ํ๊ฐ ์ธ(off-label)๋ก ์ฌ์ฉํ๊ณ ์์ต๋๋ค. **์์ ์์ :** ๊ด๋ฒ์ํ ์์ฉ์ฒด ๊ธธํญ ์์ฉ์ผ๋ก ์ธํด ์ค์ถ์ฑ ๊ตฌํ ์ ๋งค์ฐ ํจ๊ณผ์ ์ ๋๋ค. ๊ทธ๋ฌ๋ ์ฌํ ์ง์ ์์ฉ๊ณผ ์ํ-์๋๋ ๋ ๋ฆฐ ์์ฉ์ฒด ์ฐจ๋จ(์ ํ์ ์ ๋ฐ) ์ํ์ด ์์ด, ์ผ๋ฐ์ ์ผ๋ก ๋ง๋กํผํํธ๋ ์จ๋จ์ธํธ๋ก ๊ณผ ๊ฐ์ ์ต์ ํ์ ํญ๊ตฌํ ์ ๊ฐ ํจ๊ณผ๊ฐ ์๊ฑฐ๋ ์ฌ์ฉํ ์ ์๋ ๊ฒฝ์ฐ์ ๋ณด๋ฅํ์ฌ ์ฌ์ฉ๋ฉ๋๋ค. ๋ํ ๊ฐ๋ฒผ์ด ์ง์ ์์ฉ๊ณผ ์ฝํ ํญ์ฝ๋ฆฐ ํน์ฑ์ ๊ฐ์ง๊ณ ์์ต๋๋ค.
์์ฉ ๊ธฐ์ : Prochlorperazine exerts its antiemetic effects primarily by acting on the brain's emetic center and the **Chemoreceptor Trigger Zone (CRTZ)**. Its broad-spectrum efficacy is due to the antagonism of multiple receptor types: * **Dopaminergic (D2) Antagonism** โ Blocks dopamine signaling in the CRTZ, providing the primary antiemetic effect. * **Histaminergic (H1) & Cholinergic (M1) Antagonism** โ Contributes to anti-motion sickness efficacy and mild antispasmodic effects in the GI tract. * **Alpha-1 Adrenergic Antagonism** โ Causes peripheral vasodilation, which is responsible for the primary adverse effect of hypotension. It also has strong extrapyramidal effects due to central dopamine blockade in the basal ganglia.
๋๋ฌผ ์ข ๋ณ ์ฉ๋
- As an antiemetic ยท 0.5 mg/kg ยท SC or IM ยท three times a day ยท Ensure adequate hydration
- As an antiemetic ยท 0.5 mg/kg ยท IM or SC ยท q8h
- As an antiemetic ยท 0.1-0.5 mg/kg ยท IM or SC ยท q6-8h
- All uses (motion sickness, emesis) ยท 0.1-0.5 mg/kg ยท IV/IM/SC ยท q6-8h
- All uses (motion sickness, emesis) ยท 0.5-1 mg/kg ยท PO ยท q8-12h
- As an antiemetic ยท 0.5 mg/kg ยท IM or SC ยท q8h ยท Ensure adequate hydration
- As an antiemetic ยท 0.1 mg/kg ยท IM ยท q6-8h ยท Use with extreme caution in dehydrated or hypotensive animals
- As an antiemetic ยท 0.1-0.5 mg/kg ยท IM or SC ยท q6-8h
- All uses (motion sickness, emesis) ยท 0.1-0.5 mg/kg ยท IV/IM/SC ยท q6-8h
- All uses (motion sickness, emesis) ยท 0.5-1 mg/kg ยท PO ยท q8-12h
์ฉ๋์ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์ฐธ๊ณ ์๋ฃ์ ๋๋ค. ํญ์ ์ต์ ๋ผ๋ฒจ๊ณผ ๊ฐ๋ณ ํ์์ ๋ํด ํ์ธํ์ญ์์ค.
ํฌ์ฌ ๊ฒฝ๋ก
๊ธ๊ธฐ
- Hypovolemia or dehydration
- Shock
- Tetanus
- Strychnine intoxication
- Hepatic dysfunction (use with caution)
- Cardiac disease (use with caution)
์ด์๋ฐ์
- Sedation
- Hypotension
- Muscle fasciculations and tremors (extrapyramidal signs)
- Prolactin release
- Depression
- Extrapyramidal reactions (rigidity, tremors, weakness, restlessness)
์ฝ๋ฌผ ์ํธ์์ฉ
- Antacids ยท May cause reduced GI absorption of oral phenothiazines ยท moderate
- Antidiarrheal mixtures (e.g., Kaolin/pectin, bismuth subsalicylate) ยท May cause reduced GI absorption of oral phenothiazines
- CNS Depressant Agents (barbiturates, narcotics, anesthetics) ยท May cause additive CNS depression if used with phenothiazines
- Dopamine ยท Phenothiazines may decrease pressor effects
- Epinephrine ยท Phenothiazines block alpha-adrenergic receptors; concomitant epinephrine can lead to unopposed beta-activity causing vasodilation and increased cardiac rate (epinephrine reversal)
- Metoclopramide ยท Phenothiazines may potentiate the extrapyramidal effects of metoclopramide
- Opiates ยท May enhance the hypotensive effects of the phenothiazines; dosages of prochlorperazine may need to be reduced
- Organophosphate Agents ยท Phenothiazines should not be given within one month of worming with these agents as their effects may be potentiated
- Paraquat ยท Toxicity of the herbicide paraquat may be increased by prochlorperazine
- Phenytoin ยท Metabolism may be decreased if given concurrently with phenothiazines
- Physostigmine ยท Toxicity may be enhanced by prochlorperazine
- Procaine ยท Activity may be enhanced by phenothiazines
๋ชจ๋ํฐ๋ง
- Cardiac rate, rhythm, and blood pressure (if indicated and possible to measure)
- Anti-emetic/anti-spasmodic efficacy
- Hydration and electrolyte status
- Body temperature (especially if ambient temperature is very hot or cold)
- Heart rate and rhythm
- Blood pressure
- CNS status (sedation level, extrapyramidal signs)
- Liver function (with prolonged use)
๊ณผ์ฉ๋
Overdose generally presents as an exaggeration of adverse effects, particularly profound sedation, hypotension, and **extrapyramidal clinical signs** (such as torticollis, severe tremors, muscle rigidity, and excessive salivation). > **Treatment:** Acute extrapyramidal signs have been successfully treated with injectable **diphenhydramine** in humans. Hypotension should be treated with intravenous fluids; avoid epinephrine due to the risk of "epinephrine reversal" causing further vasodilation.
VetSheet ์ฝ๋ฌผ ๋ ํผ๋ฐ์ค๋ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์์ฌ๊ฒฐ์ ๋ณด์กฐ ๋๊ตฌ์ด๋ฉฐ, ์ ๋ฌธ์ ํ๋จ์ด๋ ์ ์กฐ์ฌ์ ์ต์ ๋ผ๋ฒจ์ ๋์ ํ์ง ์์ต๋๋ค.