カルプロフェン
**カルプロフェン (Carprofen)** は、獣医療で広く使用されているプロピオン酸系の非ステロイド性抗炎症薬 (NSAID) です。 * **主な用途:** 犬の変形性関節症に伴う疼痛および炎症の管理、ならびに軟部組織および整形外科手術後の術後疼痛の制御。 * **臨床上のポイント:** 非常に効果的ですが、胃腸、腎臓、または肝臓の副作用を避けるために、慎重な患者選択が必要です。 > **注意:** カルプロフェンは一般に COX-2 選択的 NSAID と見なされており、COX-1 の保護的な恒常性機能を維持しながら炎症経路を標的とします。
作用機序: Carprofen produces its analgesic and anti-inflammatory effects via the inhibition of cyclooxygenase (COX) enzymes. **Arachidonic Acid** → **Cyclooxygenase (COX)** → **Prostaglandins & Thromboxanes** * **COX-1 Sparing:** It preferentially inhibits **COX-2** (induced during inflammation) over **COX-1** (constitutively expressed for GI and renal protection). * **Additional Mechanisms:** May also inhibit the release of several prostaglandins and modulate cellular and humoral immune responses.
動物種別の用量
- Post-operative pain · 4 mg/kg · SC/IV · Single dose · One time only · Use with extreme caution in cats due to limited glucuronidation capacity; single dose only. Not approved for multi-day use in cats in many countries.
- Analgesia · 1-2 mg/kg · PO/SC · q12-24h · As needed
- Adjunct therapy for acute mastitis or respiratory disease · 1.4 mg/kg · SC/IV · Single dose · One time · Approved in some regions outside the US.
- Pain and Inflammation · 0.7 mg/kg · IV · q24h · As needed · Used primarily outside the US.
- Analgesia · 1-2 mg/kg · PO/IM/SC · q12-24h · As needed · Dosing varies significantly by species.
- Analgesia · 2-5 mg/kg · PO/SC · q12-24h · As needed · Commonly used in rabbits, guinea pigs, and rodents.
- Osteoarthritis and Pain Management · 4.4 mg/kg · PO/SC/IV · q24h or divided q12h · As needed · Can be given as a single daily dose or divided into 2.2 mg/kg twice daily.
- Analgesia · 2-4 mg/kg · PO/IM/SC · q24-72h · As needed · Metabolism is highly temperature-dependent.
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
- Bleeding disorders (e.g., Von Willebrand disease)
- Active gastrointestinal ulceration
- Hypersensitivity to carprofen or other NSAIDs
- Concurrent use with other NSAIDs or corticosteroids
有害事象
- Vomiting
- Diarrhea
- Anorexia
- Lethargy
- Gastrointestinal ulceration or bleeding
- Hepatopathy (rare, idiosyncratic)
- Renal toxicity
薬物相互作用
- Corticosteroids · Significantly increased risk of gastrointestinal ulceration and perforation. · major
- Other NSAIDs · Increased risk of GI, renal, and hepatic toxicity. · major
- ACE Inhibitors · Potential for increased risk of renal toxicity and decreased hypotensive efficacy. · moderate
- Phenobarbital · Potential for altered metabolism and increased risk of hepatotoxicity.
- Furosemide · Decreased diuretic efficacy. · moderate
モニタリング
- Baseline blood work (CBC/Chemistry panel)
- Liver enzymes (ALT, AST, ALP, Bilirubin)
- Renal parameters (BUN, Creatinine, SDMA, USG)
- Clinical signs of GI upset (vomiting, diarrhea, melena)
過量投与
**Signs of Toxicity:** * **GI:** Vomiting, diarrhea, hematemesis, melena, GI ulceration/perforation. * **Renal:** Acute kidney injury (AKI), polyuria, polydipsia. * **Hepatic:** Elevated liver enzymes, icterus. * **Neurologic:** Seizures or coma in massive overdoses. **Treatment:** 1. **Decontamination:** Emesis induction (if recent and asymptomatic), followed by activated charcoal. 2. **GI Protectants:** Omeprazole, misoprostol, sucralfate. 3. **Fluid Therapy:** IV crystalloids to support renal perfusion and promote diuresis. 4. **Monitoring:** Serial monitoring of renal and hepatic values for at least 48-72 hours.
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。