설파디메톡신

설파계 항균제

**설파디메톡신(Sulfadimethoxine)**은 수의학에서 널리 사용되는 지속성 광범위 설파계 항균제입니다. **주요 임상 요약:** * **주요 용도:** 개, 고양이, 말, 소의 호흡기, 비뇨생식기, 장관 및 연부조직 감염 치료제로 FDA 승인을 받았습니다. 또한 **콕시듐증(Coccidiosis)** 치료에 매우 자주 사용됩니다(일부 종에서는 허가 외 사용). * **항균 스펙트럼:** 많은 그람 양성균(예: 연쇄상구균, 포도상구균, 노카르디아) 및 일부 그람 음성균에 효과적입니다. 콕시듐 및 톡소플라스마와 같은 원충에 대해서도 상당한 활성을 나타냅니다. * **한계점:** 단독 사용 시 정균제로 작용합니다. 농, 괴사 조직 또는 광범위한 세포 잔해물이 있는 환경에서는 효능이 크게 감소합니다. 세균 내성이 점점 흔해지고 있습니다. * **종별 특성:** 단백질 결합률이 높고 체내 분포가 잘 됩니다. 개에서는 간 대사보다 신장 배설에 크게 의존하며, 신세뇨관에서의 광범위한 재흡수로 인해 반감기가 깁니다.

작용 기전: Sulfonamides are bacteriostatic agents that disrupt bacterial folic acid synthesis. * **Mechanism:** Sulfadimethoxine acts as a structural analog of **para-aminobenzoic acid (PABA)**. * **Pathway:** It competitively inhibits the bacterial enzyme **dihydropteroate synthase** → blocks the incorporation of PABA into **dihydropteroic acid** → prevents the biosynthesis of **tetrahydrofolic acid** (active folic acid). * **Result:** Without tetrahydrofolic acid, susceptible bacteria and protozoa cannot synthesize purines, pyrimidines, and ultimately DNA/RNA, halting replication. * *Note:* Mammalian cells are unaffected because they utilize preformed dietary folic acid rather than synthesizing it de novo.

동물 종별 용량

Sheep

Coccidiosis (Camelids - E. alpacae, E. lamae, E. punoensis, E. peruviana) · 15 mg/kg PO twice daily for 5 days · PO · q12h · 5 days · Monitor for signs of polioencephalomalacia.
Coccidiosis (Camelids - E. macusaniensis) · 110 mg/kg PO q24h · PO · q24h · 10-15 days · Administer directly to animal, not in water supply.

Cats

Susceptible infections · 25 mg/kg PO, IV, or IM once daily · PO, IV, IM · q24h
Susceptible infections · 100 mg/kg PO, IV or IM once daily · PO, IV, IM · q24h
Susceptible infections · 55 mg/kg PO, or IV, or SC initially, then 27.5 mg/kg once daily thereafter · PO, IV, SC · q24h
Coccidiosis · 50 mg/kg once daily for 10-14 days · PO · q24h · 10-14 days · Will eliminate oocyst excretion in most cats

Ferrets

Susceptible infections · 25 mg/kg PO, SC or IM once daily · PO, SC, IM · q24h
Coccidiosis · 25 mg/kg PO once daily for 14 days · PO · q24h · 14 days

Cattle

Susceptible infections · 110 mg/kg PO or IV once daily · PO, IV · q24h

투여 경로

POIVIMSC

금기

Hypersensitivity to sulfonamides, thiazides, or sulfonylurea agents
Severe renal or hepatic impairment
Doberman Pinschers (highly susceptible to poly-systemic immune complex disease)
Dehydrated patients (increased risk of crystalluria)

이상반응

Crystalluria, hematuria, and renal tubule obstruction (especially with acidic/concentrated urine)
Keratoconjunctivitis sicca (KCS or 'dry eye') in dogs
Hypersensitivity reactions (rashes, dermatitis, fever)
Bone marrow depression
Nonseptic polyarthritis (especially in Doberman Pinschers)
Focal retinitis
Vomiting and diarrhea (due to altered gut flora)
Muscle weakness, blindness, ataxia, and collapse (if injected IV too rapidly)
Tissue irritation and necrosis (if injected IM or SC)

약물 상호작용

Antacids · May decrease the oral bioavailability of sulfonamides if administered concurrently.

모니터링

Clinical efficacy and resolution of infection/coccidiosis
Hydration status and urine output
Schirmer Tear Test (STT) in dogs (monitor for KCS, especially with prolonged use)
Complete Blood Count (CBC) if used long-term (monitor for bone marrow depression)
Signs of hypersensitivity (fever, joint pain, rash)

과용량

Acute toxicity secondary to overdoses occurs only rarely in veterinary species. In addition to standard adverse effects (crystalluria, GI upset, hypersensitivity), **CNS stimulation** and **myelin degeneration** have been noted after very high dosages.

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