ํฐ์คํํ ๋ํธ๋ฅจ
ํฐ์คํํ ๋ํธ๋ฅจ์ ์ฃผ๋ก ์ ์ ๋ง์ทจ ์ ๋ ๋๋ ๋งค์ฐ ์งง์ ์์ ์ ์ํ ๋จ๋ ๋ง์ทจ์ ๋ก ์ฌ์ฉ๋๋ ์ด๋จ๊ธฐ ์์ฉ ํฐ์ค๋ฐ๋ฅด๋นํฌ๋ฅด์ฐ๊ณ ์ฝ๋ฌผ์ ๋๋ค. **์์ ์์ :** * **์ฌ๋ถํฌ ์ญํ:** ์์ฉ ์๊ฐ์ด ์งง์ ๊ฒ(10-30๋ถ)์ ๋น ๋ฅธ ๋์ฌ ๋๋ฌธ์ด ์๋๋ผ ํ๋ฅ๊ฐ ํ๋ถํ ์ค์ถ์ ๊ฒฝ๊ณ์์ ๊ทผ์ก ๋ฐ ์ง๋ฐฉ ์กฐ์ง์ผ๋ก ๋น ๋ฅด๊ฒ ์ฌ๋ถํฌ๋๊ธฐ ๋๋ฌธ์ ๋๋ค. * **์๊ฐ ํ์ด๋ ๋ฏผ๊ฐ์ฑ:** ๊ทธ๋ ์ดํ์ด๋ ๋ฐ ๊ธฐํ ์๊ฐ ํ์ด๋๋ ๋์ฌ ์ฒ๋ฆฌ์ ์ฐจ์ด์ ๋ฎ์ ์ฒด์ง๋ฐฉ์ผ๋ก ์ธํด ํ๋ณต์ด ์ง์ฐ๋ฉ๋๋ค. ํ๋กํฌํด, ์ํ์ด๋ก ๋๋ ๋ฉํ ํฅ์ํ๊ณผ ๊ฐ์ ๋์ฒด ์ ๋์ ๊ฐ ์ผ๋ฐ์ ์ผ๋ก ์ ํธ๋ฉ๋๋ค. * **์กฐ์ง ๋ ์ฑ:** ํฐ์คํํ ์ฉ์ก์ ๊ฐ์์นผ๋ฆฌ์ฑ(pH > 10)์ ๋๋ค. **ํ๊ด ์ธ ์ ์ถ์ ์ฌ๊ฐํ ์กฐ์ง ์๊ทน ๋ฐ ๊ดด์ฌ๋ฅผ ์ ๋ฐํฉ๋๋ค.** ๋ฐ๋์ ์์ ํ ์ ๋งฅ ์นดํ ํฐ๋ฅผ ํตํด ํฌ์ฌํด์ผ ํฉ๋๋ค. * **๋ถ์ ๋งฅ ์ ๋ฐ:** ์ฌ๊ทผ์ ์นดํ ์ฝ์๋ฏผ์ ๋ฏผ๊ฐํ๊ฒ ๋ง๋ค์ด ๊ฐ์์ ์ผ์์ ์ธ ์ฌ์ค ์ด๋จ๋งฅ์ ํํ ์ ๋ฐํฉ๋๋ค.
์์ฉ ๊ธฐ์ : Thiopental is a highly lipid-soluble thiobarbiturate. * **Mechanism:** It binds to the **GABA_A receptor** complex in the central nervous system. * **Pathway:** Binding โ increases the duration of chloride ion channel opening โ enhances chloride influx โ hyperpolarization of the postsynaptic neuronal membrane โ profound CNS depression, hypnosis, and anesthesia. * Due to its high lipid solubility, it rapidly crosses the blood-brain barrier, resulting in anesthesia within 15-30 seconds of IV injection.
๋๋ฌผ ์ข ๋ณ ์ฉ๋
- Anesthesia ยท 9.9-15 mg/kg ยท IV ยท once ยท depending on depth required
- Anesthesia ยท 20-22 mg/kg ยท IV ยท once ยท Given after atropine (0.7 mg/kg) IM
- Anesthesia ยท 13.2-26.4 mg/kg ยท IV ยท once ยท depending on duration of anesthesia required
- Anesthesia (unpremedicated) ยท 22 mg/kg ยท IV ยท once
- Anesthesia (after tranquilization) ยท 15.4 mg/kg ยท IV ยท once
- Anesthesia (after narcotic premedication) ยท 11 mg/kg ยท IV ยท once
- Anesthesia induction ยท 12-15 mg/kg ยท IV ยท once ยท One-third administered rapidly, additional amount to effect
- Anesthesia ยท 8.14-15.4 mg/kg ยท IV ยท once
- Deep surgical anesthesia (unweaned calves fasted 6-12h) ยท no more than 6.6 mg/kg ยท IV ยท once
- Anesthesia (calves under 2 weeks of age) ยท 15-22 mg/kg ยท IV ยท once ยท 10-12 minutes ยท Administer slowly until complete muscular relaxation
ํฌ์ฌ ๊ฒฝ๋ก
๊ธ๊ธฐ
- Absence of suitable veins for IV administration (Absolute)
- History of hypersensitivity to barbiturates (Absolute)
- Status asthmaticus (Absolute)
- Preexisting leukopenia in horses
- Use with extreme caution or avoid in greyhounds and other sight hounds
- Relative: Severe cardiovascular disease, ventricular arrhythmias, shock, increased intracranial pressure, myasthenia gravis, severe hepatic disease
์ด์๋ฐ์
- Ventricular bigeminy (dogs)
- Apnea (especially in cats)
- Arterial hypotension
- Excitement and severe ataxia during recovery (horses, if used alone)
- Transient leukopenia and hyperglycemia (horses)
- Vascular dilatation and hypoglycemia (with rapid IV administration)
- Severe tissue necrosis (if administered perivascularly)
- Prolonged recovery with repeated doses
์ฝ๋ฌผ ์ํธ์์ฉ
- Clonidine ยท IV clonidine prior to induction may reduce thiopental dosage requirements by up to 37%
- CNS Depressants ยท May enhance respiratory and CNS depressant effects
- Diazoxide ยท Potential for hypotension
- Epinephrine / Norepinephrine ยท Ventricular fibrillatory effects may be potentiated when used with thiobarbiturates and halothane
- Metoclopramide ยท Given prior to induction may reduce thiopental dosage requirements
- Midazolam ยท May potentiate hypnotic effects
- Opiates ยท Given prior to induction may reduce thiopental dosage requirements
- Phenothiazines ยท May potentiate thiopental effects; hypotension possible
- Probenecid ยท May displace thiopental from plasma proteins
- Sulfonamides ยท Thiopental and sulfas may displace one another from plasma proteins
๋ชจ๋ํฐ๋ง
- Level of hypnosis/anesthesia
- Respiratory status (rate, depth, apnea)
- Cardiac status (heart rate, rhythm, blood pressure)
๊ณผ์ฉ๋
Treatment of thiobarbiturate overdosage consists of: * **Respiratory Support:** Provide oxygen (O2) and mechanical ventilation. * **Cardiovascular Support:** Provide IV fluids and supportive care. > **Note:** Do NOT use catecholamines (e.g., epinephrine) as they may induce fatal ventricular arrhythmias in the presence of thiobarbiturates.
VetSheet ์ฝ๋ฌผ ๋ ํผ๋ฐ์ค๋ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์์ฌ๊ฒฐ์ ๋ณด์กฐ ๋๊ตฌ์ด๋ฉฐ, ์ ๋ฌธ์ ํ๋จ์ด๋ ์ ์กฐ์ฌ์ ์ต์ ๋ผ๋ฒจ์ ๋์ ํ์ง ์์ต๋๋ค.