숙시머

해독제 / 중금속 킬레이트제

숙시머(DMSA)는 소동물 및 조류의 **납 중독** 치료에 주로 사용되는 경구용 중금속 킬레이트제입니다. 디머캅프롤(BAL)의 수용성 유사체이지만, 경구 투여가 가능하고 치료 지수가 훨씬 넓다는 뚜렷한 장점이 있습니다. * **대상 독소:** 납(Pb)에 매우 효과적이며, 비소(As) 및 수은(Hg) 중독에도 잠재적인 효과가 있습니다. * **안전성:** 일반적으로 안전하고 효과적입니다. 아연, 구리, 철과 같은 대부분의 필수 미량 원소를 과도하게 킬레이트하지 않으며 위장관에서 납 흡수를 증가시키지 않습니다. > **임상 요점:** 소동물의 납 중독 치료 시, 숙시머는 가정에서 경구 투여가 가능하고 신독성이 적으며 필수 미네랄을 급격히 고갈시키지 않기 때문에 CaEDTA보다 선호되는 경우가 많습니다.

작용 기전: Succimer acts as a heavy metal chelator through its **sulfhydryl (-SH) groups**. * **Binding:** The sulfhydryl groups physically bind (chelate) heavy metal ions (such as **lead, mercury, and arsenic**) in the bloodstream and tissues. * **Complex Formation:** Heavy metal + Succimer → **Water-soluble chelate complex**. * **Excretion:** These stable, water-soluble complexes are subsequently filtered by the kidneys and excreted safely in the urine, thereby reducing the heavy metal burden in the body.

동물 종별 용량

Cats

Lead poisoning · 10 mg/kg PO three times daily for 5 days, followed by 10 mg/kg PO twice daily for 2 weeks · PO · TID then BID · 19 days
Lead poisoning · 10 mg/kg PO q8h · PO · q8h · 10 days · Blood lead levels should be rechecked a few days following the last dose; a second round may be necessary.

Birds

Lead poisoning · 15-35 mg/kg PO twice daily · PO · BID · 5 days
Lead poisoning · 30 mg/kg PO twice daily · PO · BID · minimum of 7 days · If severe neurologic signs, may supplement with one dose of CaEDTA (<50 mg/kg IM).

Dogs

Lead poisoning · 10 mg/kg PO q8h · PO · q8h · 10 days · Blood lead levels should be rechecked a few days following the last dose; a second round may be necessary.
Lead poisoning · 10 mg/kg PO three times daily for 5 days, followed by 10 mg/kg PO twice daily for 2 weeks · PO · TID then BID · 19 days

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

투여 경로

금기

Hypersensitivity to succimer
Continued exposure to the lead source (source must be removed prior to or concurrently with therapy)

이상반응

Gastrointestinal upset (vomiting, diarrhea)
Flu-like symptoms (fatigue, body aches)
Increased liver enzymes (AST, ALT)
Rash
Unpleasant sulfurous odor imparted to breath, saliva, urine, and feces

약물 상호작용

Other chelating agents (CaEDTA, dimercaprol, trientine, penicillamine) · Concomitant use is not recommended in humans due to potential for increased toxicity or altered efficacy.

모니터링

Blood lead levels (recheck a few days after completing therapy)
Gastrointestinal adverse effects
Liver enzymes (AST, ALT)
Hydration status

과용량

### Overdose & Toxicity * **Dogs:** Succimer has a relatively wide margin of safety. Doses up to 200 mg/kg/day did not cause overt toxicity. However, massive doses (300 mg/day) caused fatalities, primarily presenting with **kidney and GI tract lesions**. * **Birds:** Cockatiels are particularly sensitive to high doses. Doses of 80 mg/kg PO q12h caused a significant number of fatalities, whereas 40 mg/kg q12h did not. * **Treatment:** If an acute overdose occurs, standardized gut evacuation (emesis/lavage) followed by activated charcoal protocols are recommended.

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