ドキュセートナトリウム / ドキュセートカルシウム
**ドキュセート (Docusate)**(ナトリウム塩またはカルシウム塩として利用可能)は、エモリエント下剤および**界面活性剤型便軟化剤**です。 * **主な用途**: 小動物の便秘を緩和するために投与されます。特に、硬い便の排泄が痛みを伴う、または有害となる場合(例:肛門直腸の術後、骨盤骨折など)に有用です。 * **馬への用途**: 馬の大結腸の糞便宿便を治療するために、単独またはミネラルオイルと組み合わせて使用されます。 * **臨床のポイント**: ドキュセートは消化管の蠕動運動を著しく刺激することはありません。むしろ、便の塊を軟らかくし、排泄を容易にする働きがあります。
作用機序: Docusate acts primarily as an **anionic surfactant** (detergent). * **Surface Tension Reduction**: It lowers the surface tension of the stool → allows water and dietary fats to penetrate the ingesta and formed feces → softens the fecal mass. * **Secretory Effect**: In vivo studies show docusate increases **cAMP** concentrations in colonic mucosal cells → stimulates **ion secretion** (such as chloride) and increases fluid permeability from these cells into the colon lumen → further hydrates the stool.
動物種別の用量
- Constipation · 50 mg · PO · per day · Docusate Sodium
- Constipation · 5-10 mL of Colace · Enema · as needed · Docusate Sodium
- Constipation · 50 mg · PO · as needed · Docusate Sodium
- Constipation · 1-2 pediatric suppositories · PR · as needed · Docusate Sodium
- Constipation · 50 mg · PO · q12-24h · Docusate Sodium
- Constipation · 50 mg · PO · once daily · Docusate Calcium
- Large colon impaction (to soften) · 6-12 g/500 kg diluted in 2-4 liters of water · Nasogastric tube · q12-24h
- Constipation · 50-100 mg (total dose) · PO · q12-24h · Docusate Sodium
- Constipation · 25 mg · PO · once to twice daily · Docusate Sodium; Small Dogs
- Constipation · 50 mg · PO · once to twice daily · Docusate Sodium; Medium/large Dogs
- Constipation · Two to three 50 mg capsules or one 240 mg capsule · PO · once daily · Docusate Calcium
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
- Pre-existing fluid or electrolyte abnormalities (use with caution)
有害事象
- Cramping
- Diarrhea
- Intestinal mucosal damage (especially at high doses)
- Throat irritation (liquid preparations)
- Bitter taste (can cause hypersalivation/foaming in cats)
薬物相互作用
- Mineral Oil · Theoretically enhances absorption of mineral oil. Not a significant concern in large animals, but concurrent use in dogs/cats is not recommended. If both are necessary in small animals, separate doses by at least 2 hours. · major
モニタリング
- Clinical efficacy (resolution of constipation/impaction)
- Hydration status
- Electrolyte status (if indicated or in high doses)
過量投与
In **horses**, single doses of 0.65-1 g/kg have caused dehydration, intestinal mucosal damage, and death. Maximum therapeutic dosages of up to 0.2 g/kg have been reported. * **Clinical Signs (Horses)**: Begin 1-2 hours after dosing. Initial signs include restlessness and increased intestinal sounds, followed by increased respiratory and cardiac rates. Abdominal pain, watery diarrhea, and dehydration can occur, deteriorating over hours to days to lateral recumbency and death. * **Treatment**: Supportive care. Because of the secretory effects of high doses, hydration and electrolyte status must be monitored and corrected. GI protectants, bicarbonate, corticosteroids, and antiendotoxemic agents (NSAIDs) have been suggested as potentially helpful.
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。