フルドロコルチゾン
フルドロコルチゾンは、強力な鉱質コルチコイド作用と中等度の糖質コルチコイド作用を持つ合成コルチコステロイドです。主に犬や猫の**副腎皮質機能低下症（アジソン病）**の治療に使用され、特に承認済みの注射剤（ピバル酸デソキシコルトン）が適さない場合に用いられます。 > **臨床上の警告：** フルドロコルチゾンの鉱質コルチコイド作用はヒドロコルチゾンの約125倍、糖質コルチコイド作用は約12倍（プレドニゾロンの約3倍）です。代謝的または身体的ストレスがかかる時期には、プレドニゾロンの追加投与が必要になる場合があります。
作用機序: Acts as an **aldosterone analogue** at the mineralocorticoid receptors in the distal convoluted tubule and collecting duct of the kidneys. * **Mineralocorticoid effect:** → Increases sodium (Na+) retention and potassium (K+) excretion. * **Glucocorticoid effect:** → Possesses roughly 3 times the glucocorticoid potency of prednisolone, contributing to anti-inflammatory and metabolic effects.
動物種別の用量
- Hypoadrenocorticism (Addison's disease) · 0.01 mg/kg (starting dose); most stable patients require <0.05 mg/kg · PO · q12h (some may only require q24h) · Lifelong · Monitor absolute Na and K concentrations 4-6 hours post-pill. If on q24h dosing, check pre-pill concentrations as well.
- Hypoadrenocorticism (Addison's disease) · 0.01 mg/kg (starting dose); most stable patients require <0.05 mg/kg · PO · q12h · Lifelong · Doses as for dogs; very few reports in cats.
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
- No specific contraindications listed in the monograph, but use with caution in patients with congestive heart failure, severe hypertension, or renal disease.
- No specific contraindications available in the monograph, but generally contraindicated in patients with systemic fungal infections or known hypersensitivity.
有害事象
- Hypertension
- Oedema (including cerebral oedema)
- Hypokalaemia
- Hypercortisolism / Iatrogenic Cushing's syndrome (with long-term overdose)
- Polyuria/polydipsia (PU/PD)
- Clinical signs of hypercortisolism (with long-term overdose)
薬物相互作用
- Amphotericin B · Increased risk of severe hypokalaemia · major
- Furosemide · Increased risk of hypokalaemia due to additive potassium-depleting effects · moderate
- Thiazide diuretics · Increased risk of hypokalaemia due to additive potassium-depleting effects · moderate
モニタリング
- Absolute serum sodium concentrations
- Absolute serum potassium concentrations
- Blood pressure
- Clinical signs of hypercortisolism or hypoadrenocorticism crisis
- Body weight and hydration status
- Absolute serum sodium concentrations (4-6 hours post-pill, and pre-pill if q24h)
- Absolute serum potassium concentrations (4-6 hours post-pill, and pre-pill if q24h)
- Clinical signs of hyperadrenocorticism or hypoadrenocorticism
過量投与
Overdosage can lead to **hypertension**, **oedema** (including cerebral oedema), and **hypokalaemia**. Long-term overdosage may result in clinical signs of **hypercortisolism** (iatrogenic Cushing's syndrome, e.g., PU/PD, polyphagia, alopecia, pot-bellied appearance). Treatment involves dose reduction and supportive care.
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。