트리펠렌나민

항히스타민제 (1세대 H1 수용체 길항제)

트리펠렌나민은 주로 대동물 수의학에서 사용되는 **1세대 에틸렌디아민계 항히스타민제**입니다. 히스타민 매개 알레르기 반응 및 아나필락시스를 완화하는 데 사용됩니다. 흥미롭게도 '기립불능우 증후군(Downer cow syndrome)'에서 **중추신경계(CNS) 자극제**로 오프라벨(허가 외)로 사용되기도 합니다(천천히 정맥 주사). 1세대 항히스타민제이기 때문에 혈액-뇌 장벽(BBB)을 쉽게 통과하며, 진정에서부터 역설적 흥분(특히 말에서)에 이르기까지 심각한 중추신경계 영향을 유발할 수 있습니다. *임상 요점*: 급성 알레르기 반응에 매우 효과적이지만, 진정 작용이 적은 새로운 항히스타민제가 출시되고 많은 경구용 트리펠렌나민 제제가 단종됨에 따라 소동물 임상에서의 사용은 감소했습니다.

작용 기전: Tripelennamine acts as a **competitive antagonist at the H1-receptor**. * **Histamine Release** → Histamine binds to H1 receptors on smooth muscle, endothelium, and the CNS. * **Tripelennamine** → Competes for these receptor sites → Prevents histamine-induced bronchoconstriction, vasodilation, and increased capillary permeability. *Note*: Antihistamines do *not* inactivate histamine or prevent its degranulation/release from mast cells; they only block its downstream effects. Compared to other antihistamines, tripelennamine has **moderate sedative activity** and **minimal anticholinergic activity**.

동물 종별 용량

Cats

General antihistamine · 1 mg/kg PO q12h · PO · q12h · Oral dosage forms may no longer be obtainable
General antihistamine · 1 mg/kg IM · IM

Cattle

General antihistamine · 1.1 mg/kg (2.5 mL per 100 lbs body weight) IV (for more immediate effect) or IM q6-12h as needed · IV/IM · q6-12h · as needed
Downer Cow Syndrome (Adjunctive treatment) · 0.5 mg/kg slow IV in conjunction with parenteral mineral treatment · IV · Used as a CNS stimulant
General antihistamine · 1 mg/kg IV or IM · IV/IM

Horses

General antihistamine · 1.1 mg/kg (2.5 mL per 100 lbs body weight) IM q6-12h as needed · IM · q6-12h · as needed · Do NOT give IV. ARCI UCGFS Class 3 Drug.
General antihistamine · 1 mg/kg IM · IM · Do NOT give IV. ARCI UCGFS Class 3 Drug.

Swine

General antihistamine · 1 mg/kg IV or IM · IV/IM

Dogs

General antihistamine · 1 mg/kg PO q12h · PO · q12h · Oral dosage forms may no longer be obtainable

투여 경로

IMIVPO

금기

Intravenous (IV) administration in horses is strictly contraindicated due to severe CNS stimulation

이상반응

CNS stimulation (hyperexcitability, nervousness, muscle tremors) - especially in horses given IV
CNS depression / Sedation
Ataxia / Incoordination
Gastrointestinal disturbances

약물 상호작용

CNS Depressants (e.g., barbiturates, opioids) · Increased sedation and CNS depression
Heparin · May partially counteract the anticoagulation effects
Warfarin · May partially counteract the anticoagulation effects

모니터링

Clinical efficacy (resolution of allergic signs)
Adverse effects (CNS stimulation, sedation, ataxia)

과용량

Overdosage of tripelennamine can cause **CNS excitation, seizures, and ataxia**. * **Treatment**: Treat symptomatically and supportively if clinical signs are severe. * **Seizure Management**: Phenytoin (IV) is recommended in the treatment of seizures caused by antihistamine overdose in humans. **Barbiturates and diazepam are generally avoided** as they may exacerbate post-excitatory CNS depression.

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