틸레타민 / 졸라제팜

주사용 마취제 / 진정제

**틸레타민/졸라제팜**(일반적인 상품명: **Telazol®**)은 수의학에서 널리 사용되는 주사용 마취 및 진정제 복합제입니다. 두 가지 다른 약리학적 제제가 1:1 비율로 혼합되어 있습니다: * **틸레타민**: 케타민과 화학적으로 관련된 해리성 마취제로, 깊은 진통과 기억 상실 효과를 제공합니다. * **졸라제팜**: 벤조디아제핀계 약물로 근육 이완, 항불안 작용을 제공하며 해리성 마취제 단독 사용 시 흔히 발생하는 근육 경직 및 발작 위험을 상쇄합니다. 개와 고양이의 보정, 간단한 시술 및 마취용으로 FDA의 공식 승인을 받았으나, 말, 반추동물, 돼지, 조류, 파충류 및 다양한 특수/야생 동물에게 오프라벨로 광범위하게 사용됩니다. > **임상 요점:** 두 성분의 작용 시간은 종에 따라 다릅니다. **개**의 경우 틸레타민이 졸라제팜보다 오래 지속되어 마취 시간보다 진정 시간이 짧아집니다(회복기가 다소 거칠어질 수 있음). **고양이**의 경우 졸라제팜이 틸레타민보다 오래 지속되어 회복기 동안 더 긴 진정 상태를 유지합니다.

작용 기전: The combination works synergistically through two distinct central nervous system pathways: * **Tiletamine** acts as a non-competitive **NMDA (N-methyl-D-aspartate) receptor antagonist**. By blocking the excitatory neurotransmitter glutamate at the NMDA receptor → it prevents calcium influx into neurons → inducing a state of **dissociative anesthesia** characterized by catalepsy, profound somatic analgesia, and amnesia, while maintaining cranial nerve reflexes (e.g., palpebral, laryngeal). * **Zolazepam** acts as a **GABA-A receptor agonist**. It binds to the benzodiazepine site on the GABA-A receptor complex → enhances the binding of the inhibitory neurotransmitter GABA → increases chloride ion influx → resulting in hyperpolarization of the neuron. This provides **muscle relaxation, anxiolysis, and anticonvulsant effects**, smoothing the induction and recovery phases of the dissociative anesthetic.

동물 종별 용량

Sheep

Induction agent · Xylazine at 0.05-0.1 mg/kg IV, IM, then Telazol at 2-4 mg/kg IV (IM) · IV/IM · Once · Caution: xylazine can cause severe hypoxemia and pulmonary edema in sheep.

Goats

Induction agent · Xylazine at 0.05-0.1 mg/kg IV, IM, then Telazol at 2-4 mg/kg IV (IM) · IV/IM · Once

Cats

Procedures such as dentistry, abscess treatment, foreign body removal · 9.7-11.9 mg/kg · IM · Once · Max total dose 72 mg/kg. Use Atropine 0.04 mg/kg concurrently.
Procedures requiring mild to moderate analgesia (lacerations, castration) · 10.6-12.5 mg/kg · IM · Once · Max total dose 72 mg/kg. Use Atropine 0.04 mg/kg concurrently.
Ovariohysterectomy and onychectomy · 14.3-15.8 mg/kg · IM · Once · Max total dose 72 mg/kg. Use Atropine 0.04 mg/kg concurrently.
General anesthesia/restraint · 3-10 mg/kg IM or SC or 2-5 mg/kg IV · IM/SC/IV · Once · Based upon the combination of drugs.

Ferrets

Sedative/analgesic · 22 mg/kg IM combined with glycopyrrolate (0.01 mg/kg IM) · IM · Once · Rapid onset, but slow and rough recovery (3-4 hours)
Sedative/analgesic · 22 mg/kg · IM · Once · Telazol alone

투여 경로

IMIVSCIP

금기

Pancreatic disease
Severe cardiac disease
Severe pulmonary disease
Rabbits (due to reports of renal toxicity/nephrosis)
Large exotic cats, especially tigers (may cause seizures, permanent neurologic abnormalities, or death)
Cesarean section (crosses placenta, causes fetal respiratory depression)

이상반응

Respiratory depression and transient apnea
Pain upon IM injection (especially in cats due to low pH)
Athetoid movements (involuntary writhing/twitching)
Tachycardia (especially in dogs)
Emesis during emergence
Excessive salivation and bronchial/tracheal secretions
Vocalization and erratic/prolonged recovery
Hypothermia
Muscle rigidity or hypertonia
Hypertension or hypotension
Cyanosis, pulmonary edema, or cardiac arrest (rare/at high doses)

약물 상호작용

Inhalational Anesthetics · Dosage may need to be reduced when used concomitantly with Telazol.
Barbiturates · Dosage may need to be reduced when used concomitantly with Telazol.
Chloramphenicol · In cats, anesthesia is prolonged on average by 30 minutes. No apparent effect on recovery times in dogs.
Phenothiazines · Can cause increased respiratory and cardiac depression.
Neuromuscular Blockers (e.g., succinylcholine) · May cause enhanced or prolonged respiratory depression (extrapolated from ketamine).
Thyroid Hormones · May induce hypertension and tachycardia (extrapolated from ketamine).
Azole Antifungals (ketoconazole, itraconazole) · May increase zolazepam (benzodiazepine) levels.
Calcium Channel Blockers (diltiazem, verapamil) · May increase zolazepam levels.
Cimetidine · May increase zolazepam levels.
Macrolides (erythromycin, clarithromycin) · May increase zolazepam levels.
Opiates · May increase hypnotic effects and risk of hypotension/respiratory depression.
Phenobarbital · May decrease peak levels and AUC of zolazepam.

모니터링

Level of anesthesia and analgesia
Respiratory function (rate, depth, pulse oximetry)
Cardiovascular status (heart rate, rhythm, blood pressure)
Body temperature (monitor for hypothermia)
Eye moisture and corneal integrity (especially in cats)

과용량

The manufacturer claims a 2X margin of safety in dogs and a 4.5X margin of safety in cats. * **Clinical Signs:** Excessive respiratory depression, prolonged anesthesia, potential cardiovascular collapse. * **Treatment:** In massive overdoses, mechanically assisted ventilation should be performed if necessary. Treat other clinical signs symptomatically and supportively. * **Reversal/Stimulation:** A preliminary study in dogs suggests that **doxapram** at 5.5 mg/kg will enhance respirations and arousal after Telazol administration. > **Note:** High doses of tiletamine have caused acute tubular necrosis in New Zealand white rabbits.

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