트라조돈

세로토닌 2A 길항제/재흡수 억제제 (SARI)

트라조돈은 **세로토닌 2A 길항제/재흡수 억제제(SARI)**로 수의학에서 항불안제 및 가벼운 진정제로 널리 사용됩니다. - **임상적 유용성**: 상황적 불안(예: 뇌우, 불꽃놀이, 동물병원 방문, 여행) 및 수술 후 활동 제한이나 케이지 휴식을 돕는 데 매우 효과적입니다. - **보조 요법**: 난치성 행동 장애를 위해 SSRI(예: 플루옥세틴) 또는 가바펜틴과 자주 병용됩니다. - **안전성 프로파일**: 일반적으로 내약성이 우수하고 안전역이 넓으며, 삼환계 항우울제(TCA)에 비해 항콜린성 부작용이 적고 발작 위험이 낮습니다. - **인체 용도**: 우울증, 공격적 행동, 알코올 또는 코카인 금단 증상, 편두통 예방 및 불면증 치료에 사용됩니다.

작용 기전: Trazodone exerts its anxiolytic and sedative effects through multiple neurochemical pathways: - **Serotonin Reuptake Inhibition**: Blocks the serotonin transporter (SERT) → increases extracellular serotonin (5-HT) in the synaptic cleft. - **5-HT2A Receptor Antagonism**: Blocks 5-HT2A receptors → prevents overstimulation by serotonin, contributing to its anxiolytic and antidepressant efficacy. Downregulation of these receptors can augment the efficacy of concurrent SSRIs. - **Active Metabolite**: Hepatic metabolism produces **m-chlorophenylpiperazine (mCPP)**, which acts as a direct, non-selective serotonin receptor agonist. - **Alpha-1 Adrenergic Antagonism**: Blocks peripheral alpha-1 receptors → can cause mild vasodilation and hypotension. - **Histamine (H1) Antagonism**: Weak blockade of H1 receptors contributes to its sedative properties.

동물 종별 용량

Dogs

Adjunctive treatment of anxiety-related disorders (Daily medication only) · 1.9 mg/kg/day-16.2 mg/kg/day (mean = 7.3 mg/kg/day) · PO · daily · Begin at half target dose for 3 days to build tolerance.
Adjunctive treatment of anxiety-related disorders (As needed only) · 2.2 mg/kg/day- 14 mg/kg/day (mean 7.7 mg/kg/day) · PO · PRN
Adjunctive treatment of anxiety-related disorders (Daily medication and as needed) · 1.7 mg/kg/day-19.5 mg/kg/day (mean 7.25 mg/kg/day) · PO · daily and PRN
Adjunctive treatment of anxiety-related disorders · 1 mg/kg PO q12h for 7 days, then up to 3 mg/kg PO q12h. · PO · q12h · 7 days initially
Adjunctive treatment of anxiety-related disorders · 1-4.8 mg/kg PO twice daily; (titrate to effect in 1 mg increments every 7 days). · PO · q12h
Adjunctive treatment of anxiety-related disorders (Situational) · typical starting dose between 2-5 mg/kg and adjusting upwards as necessary to get control (maximum dose 14 mg/kg/day). · PO · PRN · Given about an hour prior to the onset of anxiety.

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

투여 경로

금기

Hypersensitivity to trazodone
Concurrent use of MAO inhibitors (e.g., amitraz, selegiline)
Glaucoma
History of seizures
Urinary retention
Severe liver disease

이상반응

Sedation
Lethargy
Ataxia
Cardiac conduction disturbances
Increased anxiety (paradoxical)
Aggression (paradoxical)
Vomiting/gagging
Increased excitement
Increased appetite
Colitis
Serotonin syndrome (rare, usually with concurrent serotonergic drugs)
Vomiting
Excitability
Dry mouth
Third eyelid protrusion (in cats)

약물 상호작용

Antihypertensive drugs · May increase reductions in blood pressure and cause hypotension
Aspirin · Increase risk for GI bleeding; monitor
Azole antifungals (e.g., ketoconazole, fluconazole) · May increase trazodone blood levels
CNS depressants · Use with trazodone may cause additive CNS depressant effects
Digoxin · Trazodone may increase digoxin levels
Macrolide antibiotics (e.g., erythromycin, clarithromycin) · May increase trazodone blood levels
Metoclopramide · Increased risk for serotonin syndrome
NSAIDs · Increased risk for GI bleeding; monitor
Phenothiazines · May increase trazodone blood levels; cause additive CNS effects
SSRI antidepressants (e.g., fluoxetine) · Increased risk for serotonin syndrome. Commonly used together, but monitor closely.
Monoamine oxidase inhibitors (MAOIs) · Contraindicated; high risk of serotonin syndrome · major
Chlorphenamine · Metabolized by CYP450 2D6; potential for altered metabolism and toxicity · moderate
Cimetidine · Metabolized by CYP450 2D6; potential for altered metabolism and toxicity · moderate

모니터링

Clinical efficacy (behavioral calming)
Adverse effects (sedation, GI upset, paradoxical excitement)
Signs of serotonin syndrome (vomiting, diarrhea, seizures, hyperthermia, hyperesthesia, mydriasis)
Renal function (in patients with pre-existing renal disease)
Signs of serotonin syndrome (tremors, agitation, hyperthermia)
Efficacy of anxiety reduction

과용량

No specific information is available regarding trazodone overdoses in veterinary patients. In humans, the incidence of serious toxicity from trazodone overdose alone is low compared with tricyclic antidepressant overdoses. In the event of a substantial overdose, contact an animal poison control center for guidance. Monitor for profound sedation, ataxia, hypotension, and signs of serotonin syndrome.

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