로미피딘

알파-2 작용제 진정 및 진통제

로미피딘은 수의학에서 주로 진정, 근육 이완 및 진통 목적으로 사용되는 강력한 **알파-2 아드레날린 수용체 작용제**입니다. 주요 임상적 특징은 다음과 같습니다: * **말 임상 적용**：일반적으로 사용되는 알파-2 작용제(자일라진 또는 데토미딘 등) 중 **가장 긴 진정 시간**을 제공하며, 진정 용량에서 **운동 실조가 적게** 나타나는 경향이 있어 기립 상태의 시술 중 말이 더 안정적으로 서 있을 수 있게 하므로 말 임상에서 매우 선호됩니다. * **소동물 적용**：미국에서는 말용으로만 FDA 승인을 받았으나, 유럽의 여러 국가에서는 개와 고양이의 신뢰할 수 있는 마취 전 투약 및 진정제로 승인되어 사용되고 있습니다. * **진통과 진정의 비교**：대부분의 알파-2 작용제와 마찬가지로 진통 효과의 지속 시간은 눈에 보이는 진정 시간보다 현저히 짧습니다. > **임상 핵심**：동물(특히 말)이 깊게 진정된 것처럼 보이더라도 청각이나 촉각 자극에 갑작스럽고 격렬하게 반응할 수 있습니다. 항상 안전한 취급 수칙을 준수하십시오.

작용 기전: Romifidine exerts its effects by binding to and stimulating **alpha-2 adrenergic receptors** located in the central and peripheral nervous systems. * **Central Nervous System (CNS)**: Presynaptic alpha-2 activation causes feedback inhibition of **norepinephrine** release → resulting in dose-dependent sedation, muscle relaxation, and analgesia. It also reduces overall sympathetic outflow. * **Cardiovascular System**: Postsynaptic alpha-2 activation in peripheral vascular smooth muscle → initial **vasoconstriction** and transient hypertension → triggers a secondary vagal reflex → **bradycardia** and subsequent hypotension. * **Metabolic & GI**: Inhibits insulin release from pancreatic beta cells → transient **hyperglycemia**. It also decreases gastrointestinal motility and alters thermoregulatory mechanisms.

동물 종별 용량

Cats

For sedation · 200-400 micrograms/kg IV or IM · IV/IM · Single dose · IM gives sedation in ~10 mins, persists ~60 mins. IV onset ~5 mins. Atipamezole (400 mcg/kg IM) reverses 400 mcg/kg romifidine.
As a preanesthetic · 200 micrograms/kg IM 10-15 minutes prior to giving ketamine at 10 mg/kg IM · IM · Single dose · Provides surgical anesthesia for up to 30 mins. 400 mcg/kg extends period. Top-up dose of 50% initial doses can prolong anesthesia.
As an analgesic adjunct · 20-40 micrograms/kg IM, IV · IM/IV · Single dose · May combine with an anticholinergic agent in exercise-tolerant patients free from heart disease.

Cattle

For epidural anesthesia for paralumbar analgesia or laparotomy · Romifidine 50 micrograms/kg plus morphine 0.1 mg/kg · Epidural · Single dose · 12 hours maximum · Extra-label use. Contact FARAD for withdrawal times.

Horses

For sedation and analgesia · 40-120 micrograms/kg IV slowly one time · IV · Single dose · Onset 30 sec to 5 mins, subsides over 2-4 hours. Duration of analgesia is shorter than sedation.
As a preanesthetic · 100 micrograms/kg as slow, single IV injection · IV · Single dose · Induce anesthesia after maximal sedation is achieved (2-4 mins). Decrease anesthetic doses due to sparing effects.

Dogs

For sedation · 40-120 micrograms/kg IV, IM or SQ · IV/IM/SQ · Single dose · IV causes sedation in ~5 mins. SC/IM delayed to ~30 mins and depth is lower. Atipamezole (200 mcg/kg IM) reverses 120 mcg/kg romifidine.

투여 경로

IVIMSQEpidural

금기

Known hypersensitivity to romifidine
Concurrent use with intravenous potentiated sulfonamides
Preexisting cardiac conditions, arrhythmias, or severe cardiovascular compromise
Severe respiratory, hepatic, or renal disease
Pregnancy (especially last month in horses, and throughout pregnancy in dogs/cats)
Shock or severe systemic debilitation

이상반응

Bradycardia (can be profound)
First- and second-degree atrioventricular (AV) heart block
Sinus arrhythmias
Initial hypertension followed by hypotension
Ataxia and muscle tremors
Sweating and piloerection (horses)
Vomiting (especially common in cats)
Transient hyperglycemia
Decreased gastrointestinal motility (flatulence, mild colic in horses)
Increased urination
Altered thermoregulation (hypothermia or hyperthermia)
Swelling of face, lips, and upper airways; stridor (horses)
Paradoxical excitation (rare)

약물 상호작용

Intravenous Potentiated Sulfonamides (e.g., trimethoprim/sulfa) · May cause fatal dysrhythmias; concurrent use is strictly contraindicated.
Other Alpha-2 Agonists (e.g., xylazine, dexmedetomidine) & Epinephrine · Additive cardiovascular and CNS effects; epinephrine may potentiate adverse effects and arrhythmias.
Phenothiazines (e.g., acepromazine) · Can result in severe, compounding hypotension.
Anesthetics, Opiates, Sedatives/Hypnotics · Synergistic CNS depression; significantly reduces the required dose of induction and maintenance anesthetics. Increased risk of arrhythmias with thiopental, ketamine, or halothane.

모니터링

Level of sedation and analgesia
Respiratory rate and effort
Heart rate and rhythm (ECG recommended during anesthesia)
Blood pressure (especially during general anesthesia)
Body temperature (monitor for hypothermia during prolonged procedures)

과용량

In **horses**, experimental doses up to 5X (600 mcg/kg) caused sinus bradycardia, 2nd-degree heart block, occasional apnea, mild respiratory stridor, deep sedation, frequent urination, and sweating. No clinically significant alterations in blood gases or chemistries were noted. In **dogs**, doses up to 10X (1 mg/kg IV daily for 4 weeks) resulted in no serious adverse effects reported. **Treatment**: If necessary, an alpha-2 antagonist such as **atipamezole** (30-80 mcg/kg) or **yohimbine** can be administered to rapidly reverse the sedation and cardiovascular adverse effects.

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