ํฐ๋๋ค์กธ
**ํฐ๋๋ค์กธ(Tinidazole)**์ ๋ฉํธ๋ก๋๋ค์กธ๊ณผ ๊ตฌ์กฐ์ , ์ฝ๋ฆฌํ์ ์ผ๋ก ์ ์ฌํ 2์ธ๋ **5-๋ํธ๋ก์ด๋ฏธ๋ค์กธ**๊ณ ํญ๊ท ๋ฐ ํญ์์ถฉ์ ์ ๋๋ค. ์ฃผ์ ์์์ ํน์ง: * **๋ฐ๊ฐ๊ธฐ ์ฐ์ฅ**: ๋ฉํธ๋ก๋๋ค์กธ์ ๋นํด ์์ฉ ์๊ฐ์ด ๊ธธ์ด ํฌ์ฌ ํ์๋ฅผ ์ค์ผ ์ ์์ต๋๋ค (์: ๋ฉํธ๋ก๋๋ค์กธ์ ํ๋ฃจ 2ํ ํฌ์ฌํ์ง๋ง, ๊ณ ์์ด์์ ํฐ๋๋ค์กธ์ ํ๋ฃจ 1ํ ํฌ์ฌ ๊ฐ๋ฅ). * **ํ๊ธฐ์ฑ ๊ท ์ ๋ํ ํจ๋ฅ**: ์ ๋ ํ๊ธฐ์ฑ ๊ท ์ ๋ํด ์ฐ์ํ ํ์ฑ์ ๋ณด์ด๋ฉฐ, ํนํ ๋ฐ๋ ค๊ฒฌ์ ์๋ชธ์์ ๋ฐ๊ฒฌ๋๋ *Porphyromonas* ์ข ์ ํจ๊ณผ์ ์ด์ด์ ์ฌ๊ฐํ ์น๊ณผ ๋ฐ ๊ตฌ๊ฐ ๊ฐ์ผ์ ๋งค์ฐ ์ ์ฉํฉ๋๋ค. * **ํญ์์ถฉ ํ์ฑ**: ์ง์๋์, ์ด์ง์๋ฉ๋ฐ, ํธ๋ฆฌ์ฝ๋ชจ๋์ค, ๋ฐ๋ํฐ๋ ๊ฐ์ผ์ ๋์ฒด ์น๋ฃ์ ๋ก ์ฌ์ฉ๋ฉ๋๋ค. * **ํ์์ธ๋ชจํธ๋ชจ์ถฉ(Tritrichomonas foetus)**: ๊ณ ์์ด์ T. foetus ๊ฐ์ผ์๋ ์ผ๋ฐ์ ์ผ๋ก ๋ก๋๋ค์กธ์ด ์ฐ์ ์ ์ผ๋ก ์ ํ๋์ง๋ง, ํฐ๋๋ค์กธ๋ ๋์ฒด์ ๋ก ์ฐ๊ตฌ๋ ๋ฐ ์์ต๋๋ค. ๋จ, ์ผ๋ถ ๊ฒฝ์ฐ ์์ถฉ์ ์์ ํ ๋ฐ๋ฉธํ๊ธฐ๋ณด๋ค๋ ๋ฐฐ์ถ์ ์ต์ ํ๋ ๋ฐ ๊ทธ์น ์ ์์ต๋๋ค. > **์์ ํ**: ์ฝ๋ฌผ์ ์ด๋ง์ด ๋งค์ฐ ๊ฐํ๋ฏ๋ก, ํนํ ์ด๋ง์ผ๋ก ์ธํด ์นจ์ ๋ง์ด ํ๋ฆฌ๊ฑฐ๋ ์ฝ์ ๊ฑฐ๋ถํ ์ ์๋ ๊ณ ์์ด ํ์์๊ฒ๋ ์บก์๋ก ์กฐ์ ํ๊ฑฐ๋ ํฅ์ด ์ฒจ๊ฐ๋ ํํ์ก์ผ๋ก ๋ง๋๋ ๊ฒ์ด ๊ฐ๋ ฅํ ๊ถ์ฅ๋ฉ๋๋ค.
์์ฉ ๊ธฐ์ : Tinidazole is a prodrug that requires activation within susceptible organisms. * **Uptake**: The drug diffuses into the target anaerobic bacteria or protozoa. * **Reduction**: Inside the cell, the nitro group of tinidazole is reduced by electron-transport proteins (such as **ferredoxin** or **nitroreductase** enzymes) specific to anaerobic metabolism. * **DNA Disruption**: This reduction โ generates highly reactive, unidentified polar nitro radical anions โ these radicals bind to and disrupt **DNA and nucleic acid synthesis** โ leading to strand breakage and rapid cell death. This mechanism makes it rapidly **bactericidal**, **trichomonacidal**, and **amebicidal**.
๋๋ฌผ ์ข ๋ณ ์ฉ๋
- Stomatitis, anaerobic infections ยท 15 mg/kg PO q24h ยท PO ยท q24h ยท 7 days
- Tritrichomonas foetus (experimental) ยท 30 mg/kg PO once daily ยท PO ยท q24h ยท 14 days ยท Decreased fecal shedding but failed to eradicate infection in 2 of 4 cats.
- Susceptible anaerobic infections ยท 10-15 mg/kg PO q12h ยท PO ยท q12h
- Stomatitis, anaerobic infections ยท 15-25 mg/kg PO q12h ยท PO ยท q12h ยท 7 days
- Giardiasis ยท 44 mg/kg PO q24h ยท PO ยท q24h ยท 6 days ยท Potentially useful for trichomoniasis, amebiasis, and balantidiasis.
์ฉ๋์ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์ฐธ๊ณ ์๋ฃ์ ๋๋ค. ํญ์ ์ต์ ๋ผ๋ฒจ๊ณผ ๊ฐ๋ณ ํ์์ ๋ํด ํ์ธํ์ญ์์ค.
ํฌ์ฌ ๊ฒฝ๋ก
๊ธ๊ธฐ
- Hypersensitivity to tinidazole or other 5-nitroimidazoles (e.g., metronidazole, ronidazole)
- Food-producing animals (prohibited use)
์ด์๋ฐ์
- Vomiting
- Inappetence
- Diarrhea
- Neurotoxicity (ataxia, nystagmus, seizures)
- Hypersalivation (due to bitter taste)
์ฝ๋ฌผ ์ํธ์์ฉ
- Alcohol ยท May induce a disulfiram-like reaction (nausea, vomiting, cramps).
- Cimetidine ยท May decrease the metabolism of tinidazole and increase the likelihood of dose-related side effects.
- Ketoconazole ยท May decrease the metabolism of tinidazole and increase the likelihood of dose-related side effects.
- Cyclosporine ยท Tinidazole may increase the serum levels of cyclosporine.
- Tacrolimus (systemic) ยท Tinidazole may increase the serum levels of tacrolimus.
- Fluorouracil (systemic) ยท Tinidazole may increase the serum levels of fluorouracil and increase the risk of toxicity.
- Lithium ยท Tinidazole may increase lithium serum levels and increase the risk for lithium toxicity.
- Oxytetracycline ยท May antagonize the therapeutic effects of metronidazole (and presumably tinidazole).
- Phenobarbital ยท May increase the metabolism of tinidazole thereby decreasing blood levels.
- Rifampin ยท May increase the metabolism of tinidazole thereby decreasing blood levels.
- Phenytoin ยท May increase the metabolism of tinidazole thereby decreasing blood levels.
- Warfarin ยท May prolong the prothrombin time (PT). Avoid concurrent use if possible; otherwise, intensify monitoring.
๋ชจ๋ํฐ๋ง
- Clinical efficacy in treating the infection
- Gastrointestinal tolerance
- Neurological signs (ataxia, nystagmus, seizures)
๊ณผ์ฉ๋
Very limited information is available. In rodent studies, the oral LD50 was >3.6 g/kg (mice) and >2 g/kg (rats). Treatment of acute overdoses is **symptomatic and supportive**. * **Decontamination**: Gastric lavage or induction of emesis may be helpful if performed shortly after ingestion and the patient is neurologically appropriate. * **Clearance**: Hemodialysis can remove approximately 43% of the drug in the body (based on human data) in a 6-hour session.
VetSheet ์ฝ๋ฌผ ๋ ํผ๋ฐ์ค๋ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์์ฌ๊ฒฐ์ ๋ณด์กฐ ๋๊ตฌ์ด๋ฉฐ, ์ ๋ฌธ์ ํ๋จ์ด๋ ์ ์กฐ์ฌ์ ์ต์ ๋ผ๋ฒจ์ ๋์ ํ์ง ์์ต๋๋ค.