水酸化アルミニウム
水酸化アルミニウムは経口投与される化合物で、獣医療では主に**慢性腎臓病（CKD）**の患者における高リン血症を管理するための**腸管内リン吸着剤**として使用されます。 * また、胃腸潰瘍の治療または予防のための**胃制酸薬**としても利用されます。 * > **臨床のポイント：** 人間用の液体制酸薬（ミント風味の懸濁液など）は市販されていますが、犬や猫には非常に不評なことが多いです。調剤された乾燥粉末はほぼ無味であり、缶詰のフードに混ぜるとはるかに容易に投与できます。
作用機序: * **Phosphate Binding:** In the gastrointestinal tract, **aluminum** binds to dietary **phosphate** → forms insoluble **aluminum phosphate** → excreted in the feces. This prevents the systemic absorption of phosphorus, thereby lowering serum phosphorus levels. * **Antacid:** Neutralizes gastric hydrochloric acid → increases gastric pH → reduces pepsin activity, providing a protective effect on the gastric mucosa.
動物種別の用量
- Hyperphosphatemia · Initially at 30-90 mg/kg per day · PO · divided with meals · Dosage must be individualized. Capsules or suspension are preferred as they are more easily mixed with food and dispersed throughout ingesta.
- Hyperphosphatemia · 15-45 mg/kg · PO · q12h
- As an antacid · ¼ tablet · PO · q6h · Aluminum hydroxide tablets
- As an antacid · 30 grams/animal · PO · as needed
- Adjunctive gastroduodenal ulcer therapy in foals · 15 mL (total dose) · PO · 4 times a day · Aluminum/magnesium hydroxide suspension
- General · 1 mL/animal · PO · as needed · Chinchillas; Aluminum hydroxide gel
- General · 0.5-1 mL/animal · PO · as needed · Guinea pigs
- Hyperphosphatemia · 30-100 mg/kg/day · PO · with meals
- Hyperphosphatemia · 30-90 mg/kg/day · PO · prior to meals · Aluminum hydroxide gel, dried powder. The dried powder is virtually tasteless and accepted readily by most cats when mixed with canned food.
- Hyperphosphatemia · 15-45 mg/kg · PO · q12h
- Adjunctive therapy for gastric ulcers · 2-10 mL · PO · q2-4h · Aluminum hydroxide suspension or aluminum hydroxide/magnesium hydroxide suspension
- Adjunctive therapy for gastric ulcers · ½-1 tablet or strength · PO · q6h · Aluminum hydroxide tablets
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Use with caution in patients with delayed gastric emptying or severe constipation
- Use with caution in patients with severe renal failure due to risk of aluminum accumulation
有害事象
- Constipation
- Aluminum toxicity (neuromuscular weakness, microcytosis) with chronic use or severe renal impairment
- Hypophosphatemia (if over-supplemented)
薬物相互作用
- Isoniazid · Decreased absorption; separate oral doses by two hours
- Penicillamine · Decreased absorption; separate oral doses by two hours
- Phenothiazines · Decreased absorption; separate oral doses by two hours
- Tetracyclines · Decreased absorption; separate oral doses by two hours
- Thyroid Hormones · Decreased absorption; separate oral doses by two hours
モニタリング
- Serum phosphorus (after a 12-hour fast), initially at 10-14 day intervals; once 'stable', at 4-6 week intervals
- Neuromuscular effects (signs of aluminum toxicity)
- Progressive decreases in mean cell volume (MCV) and microcytosis
過量投与
Chronic overdosage or accumulation in patients with severe renal failure can lead to **aluminum toxicity**. * Signs of toxicity include neuromuscular effects (weakness, stumbling, difficulty walking) and hematological changes (progressive decreases in mean cell volume [MCV] and microcytosis).
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。