폴리스티렌설폰산나트륨

양이온 교환 수지 (고칼륨혈증 치료제)

폴리스티렌설폰산나트륨(SPS)은 수의학 환자에서 고칼륨혈증(혈중 칼륨 수치가 높은 상태)의 보조 치료제로 주로 사용되는 비흡수성 **양이온 교환 수지**입니다. > **임상 요점:** 작용 발현이 느리기 때문에(수시간~수일), SPS는 급성이고 생명을 위협하는 고칼륨혈증의 단독 요법으로 사용해서는 **안 됩니다**. 응급 상황에서는 더 빠른 작용을 하는 치료법(예: 정맥 내 글루콘산칼슘, 속효성 인슐린 및 포도당, 또는 중탄산나트륨)을 우선해야 합니다. 주요 특징: * 위장관에서 나트륨 이온을 칼륨 이온과 교환하여 작용합니다. * 경구 투여 시 변비를 예방하고 수지-칼륨 복합체의 배출을 촉진하기 위해 하제(예: 소르비톨)와 함께 투여하는 경우가 많습니다. * 고칼륨혈증의 근본 원인(예: 급성 신손상, 요로 폐색, 부신피질기능저하증)을 항상 파악하고 동시에 치료해야 합니다.

작용 기전: SPS acts as a cation exchange resin in the gastrointestinal tract. * **Mechanism:** After oral or rectal administration, the resin exchanges its **sodium ions** for hydrogen ions in the acidic environment of the stomach. As it travels into the large intestine, where potassium concentration is higher, it exchanges these ions for **potassium ions**. * **Binding Capacity:** While theoretically capable of exchanging up to 3.1 mEq of potassium per gram, in vivo it typically exchanges approximately **1 mEq of potassium per gram** of resin. * **Excretion:** The resin, now bound to potassium, is excreted unchanged in the feces, thereby physically removing potassium from the body. * **Sodium Load:** Because it releases sodium in exchange for potassium, it delivers a significant sodium load to the patient, which can be problematic in sodium-restricted individuals.

동물 종별 용량

Horses

Life-threatening hyperkalemia in neonatal foals · 15 grams of resin in 100 mL of 10% dextrose · Enema · Once/As directed · As needed · Monitor serum potassium and sodium closely.

Dogs

Hyperkalemia · 2 grams of resin/kg divided into 3 daily doses (suspended in 3-4 mL water/gram or commercial suspension). Severe hyperkalemia: 3-4 times the normal amount may be given. · PO/Enema · q8h · As needed · If PO, give with a cathartic. If enema, do NOT use a cathartic (must retain in colon for at least 30 mins). Enema prep: add 15g per 100 mL of 1% methylcellulose or 10% dextrose.
Mild hyperkalemia (<6 mEq/L) · 2 grams/kg in 3-4 divided doses with 20% sorbitol · PO/Enema · q6-8h · As needed · May also be given as an enema without sorbitol.

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

투여 경로

PORectal (Enema)

금기

Patients on severely restricted sodium diets
Severe congestive heart failure (CHF)
Severe hypertension
Oliguric or anuric acute kidney injury (where sodium load cannot be excreted)
Conditions predisposing to severe constipation or bowel obstruction

이상반응

Constipation (fecal impaction reported rarely)
Anorexia
Vomiting
Nausea
Hypokalemia (from overuse)
Hypocalcemia
Hypomagnesemia
Sodium retention / Hypernatremia

약물 상호작용

Antacids (Calcium or Magnesium containing) · SPS may bind with magnesium or calcium, preventing bicarbonate ion neutralization and potentially leading to systemic metabolic alkalosis. Concurrent use is not recommended.
Laxatives (Calcium or Magnesium containing) · Similar to antacids, can lead to metabolic alkalosis and reduced potassium-binding efficacy.

모니터링

Serum electrolytes (sodium and potassium at least once daily; calcium, magnesium)
Acid/base status
ECG (if warranted to monitor cardiac effects of hyper/hypokalemia)
Fecal output and consistency (monitor for constipation/impaction)

과용량

Overdosage or overuse may lead to severe electrolyte imbalances, including **hypokalemia** (low potassium), **hypocalcemia** (low calcium), and **hypomagnesemia** (low magnesium), as well as significant **sodium retention**. Treatment is symptomatic and supportive. Discontinue the drug immediately and correct electrolyte deficits based on frequent serum chemistry monitoring.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.