트리메프라진 및 프레드니솔론

페노티아진계 항히스타민제 및 코르티코스테로이드

**트리메프라진 및 프레드니솔론**(일반적으로 Temaril-P®로 알려짐)은 주로 반려견의 소양증(가려움증)과 기침을 관리하기 위해 수의학에서 널리 사용되는 복합제입니다. * **트리메프라진**(알리메마진으로도 알려짐)은 페노티아진 유도체로, 강력한 항히스타민, 가벼운 진정 및 진해 작용을 합니다. * **프레드니솔론**은 중간 작용형 글루코코르티코이드로 강력한 항염증 및 면역 억제 효과를 제공합니다. > **임상 요점:** 항히스타민제와 코르티코스테로이드를 결합하는 시너지 효과를 통해 더 낮은 용량의 프레드니솔론으로도 동일한 항소양 효과를 얻을 수 있습니다. 이러한 "스테로이드 절약" 접근법은 임상 증상을 효과적으로 조절하면서 장기적인 글루코코르티코이드 유발 부작용의 위험을 최소화하는 데 도움이 됩니다.

작용 기전: The drug exerts its effects through two distinct mechanisms: * **Trimeprazine**: Acts primarily as a competitive antagonist at **H1-histamine receptors**, preventing histamine-induced capillary permeability, vasodilation, and pruritus. It also exhibits central antitussive and sedative properties by antagonizing central **dopamine (D2)** and **muscarinic (M1)** receptors in the brainstem and reticular activating system. * **Prednisolone**: Diffuses across cell membranes and binds to **cytosolic glucocorticoid receptors**. The receptor-ligand complex translocates to the nucleus → alters gene transcription → induces production of lipocortin-1 (annexin-1) → inhibits **phospholipase A2**. This blocks the release of arachidonic acid, thereby suppressing the synthesis of key inflammatory mediators, including **prostaglandins** and **leukotrienes**.

동물 종별 용량

Dogs

Antipruritic and antitussive therapy · Weight up to 10 lb = 1/2 tab PO twice daily; 11-20 lb = 1 tablet twice daily; 21-40 lb = 2 tablets twice daily; over 40 lb = 3 tablets twice daily. After 4 days reduce dose to 1/2 of initial dose or to an amount just sufficient to maintain remission of symptoms; adjust as necessary. · PO · twice daily · After 4 days reduce dose
Treatment of pruritus · 1 tablet per 10 kg of body weight once daily for 3-5 days, then every other day. · PO · once daily then every other day · 3-5 days then every other day · Giving with an EFA (essential fatty acid) may reduce the dose and frequency, if not the need for, glucocorticoids.
Atopic dermatitis · 1 tablet of Temaril-P per 5 kg body weight q12h for one week, then once daily for one week, then q48h (every other day). · PO · q12h then once daily then q48h · 1 week q12h, 1 week once daily, then q48h

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

투여 경로

금기

Systemic fungal infections
Hypovolemia or shock
Tetanus or strychnine intoxication
Late pregnancy (last trimester) due to risk of inducing parturition

이상반응

Sedation
Depression
Hypotension
Extrapyramidal reactions (rigidity, tremors, weakness, restlessness)
Polyuria (increased urination)
Polydipsia (increased thirst)
Polyphagia (increased appetite)
Elevated liver enzymes
Weight loss or weight gain
Vomiting
Diarrhea
Iatrogenic hyperadrenocorticism (Cushing's syndrome) with chronic use
Delayed wound healing
Osteoporosis
Increased susceptibility to infections

약물 상호작용

ACE Inhibitors · Phenothiazines may increase hypotensive effects
Amphotericin B · Concomitant use with glucocorticoids may cause severe hypokalemia
Antacids · May cause reduced GI absorption of oral phenothiazines
Antidiarrheal mixtures (Kaolin/pectin, bismuth) · May cause reduced GI absorption of oral phenothiazines
Anticholinesterase agents (pyridostigmine, neostigmine) · In myasthenia gravis patients, concomitant use may lead to profound muscle weakness
Aspirin (salicylates) · Glucocorticoids may reduce salicylate blood levels
Cisapride · Increased risk for cardiac arrhythmias when used with phenothiazines
CNS Depressants (barbiturates, narcotics, anesthetics) · May cause additive CNS depression
Cyclophosphamide · Glucocorticoids may inhibit hepatic metabolism of cyclophosphamide
Cyclosporine · May mutually inhibit hepatic metabolism, increasing blood levels of both drugs
Digoxin · Increased risk for arrhythmias secondary to glucocorticoid-induced hypokalemia
Diuretics, potassium-depleting (furosemide, thiazides) · Concomitant use with glucocorticoids may cause hypokalemia

모니터링

Efficacy (reduction in pruritus or coughing)
Degree of sedation
Anticholinergic effects
Adverse effects associated with corticosteroids (e.g., PU/PD, weight changes, liver enzyme elevations)

과용량

Acute overdosage should be handled similarly to phenothiazine (e.g., acepromazine) toxicity. Overdose may cause profound sedation, depression, hypotension, and extrapyramidal signs (tremors, rigidity). Treatment is largely supportive and symptomatic. Do not use epinephrine for hypotension as it may cause further vasodilation (epinephrine reversal); use norepinephrine or phenylephrine if pressors are required.

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