フルルビプロフェン
フルルビプロフェンは局所眼用非ステロイド性抗炎症薬（NSAID）です。主に眼内手術（白内障手術など）中の術中縮瞳の予防や、眼の炎症の管理に使用されます。 **臨床のポイント：** 前ぶどう膜炎の制御や手術誘発性の縮瞳の予防には非常に効果的ですが、フルルビプロフェンのような局所NSAIDは角膜上皮の治癒を遅らせる可能性があるため、既存の角膜潰瘍がある患者には細心の注意を払って使用する必要があります。
作用機序: Inhibits **cyclooxygenase (COX)** enzymes, thereby blocking the synthesis of **prostaglandins** from arachidonic acid. → Reduces ocular inflammation and provides analgesic action. → Prevents prostaglandin-mediated miosis (constriction of the iris sphincter) during intraocular surgery, acting independently of cholinergic mechanisms.
動物種別の用量
- Prevention of intraocular surgical miosis · 1 drop in the affected eye(s) · Topical · Every 30 minutes for 4 doses prior to surgery · Pre-operative · Standard pre-surgical protocol
- Ocular inflammation (uveitis) · 1 drop in the affected eye(s) · Topical · q6h to q12h · As directed by veterinarian · Monitor for corneal ulceration
- Prevention of intraocular surgical miosis · 1 drop in the affected eye(s) · Topical · Every 30 minutes for 4 doses prior to surgery · Pre-operative · Standard pre-surgical protocol
- Ocular inflammation (uveitis) · 1 drop in the affected eye(s) · Topical · q6h to q12h · As directed by veterinarian · Monitor for corneal ulceration
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
- Hypersensitivity to flurbiprofen or other NSAIDs
- Active corneal ulceration (relative contraindication)
- Bleeding disorders
- Hypersensitivity to NSAIDs
- Active intraocular bleeding
- Corneal ulceration (use with extreme caution)
- Epithelial herpes simplex keratitis
有害事象
- Transient ocular stinging or burning upon application
- Delayed corneal healing
- Increased risk of ocular bleeding during surgery
- Corneal melting (rare but severe)
- Transient stinging or burning upon instillation
- Ocular irritation
- Increased bleeding tendency of ocular tissues (rare)
薬物相互作用
- Topical Corticosteroids · Concurrent use may increase the risk of delayed corneal healing and severe complications such as corneal melting. · moderate
- Topical Prostaglandin Analogues (e.g., Latanoprost) · NSAIDs may blunt the intraocular pressure-lowering efficacy of topical prostaglandins. · minor
- Topical prostaglandins (e.g., Latanoprost) · NSAIDs may decrease the intraocular pressure-lowering efficacy of topical prostaglandin analogues. · minor
モニタリング
- Resolution of ocular inflammation (flare and cells in the anterior chamber)
- Intraocular pressure (IOP)
- Corneal integrity (via fluorescein staining)
- Resolution of ocular inflammation
- Maintenance of pupillary dilation during surgery
- Corneal integrity (via fluorescein staining) if used long-term
過量投与
Topical overdose is unlikely to cause systemic toxicity due to the small volume administered. Ocular overdosage may lead to increased local irritation, hyperemia, and delayed corneal healing. If significant overexposure occurs, flush the eye with sterile saline.
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。