ヒドロコルチゾン
低力価の局所用コルチコステロイドと見なされており、局所的なそう痒性および/または炎症性疾患の補助治療に有用です。高力価のステロイドと比較してリスクが低いため、特に広範囲や小型の患者に対する最初の選択肢として適しています。
作用機序: Corticosteroids are non-specific anti-inflammatory agents. They act by inducing **phospholipase A2 inhibitory proteins (lipocortins)** in cells → reducing the formation, activity, and release of endogenous inflammatory mediators (e.g., **histamine, prostaglandins, kinins**). They also reduce DNA synthesis via an anti-mitotic effect on epidermal cells and inhibit the migration of leukocytes and macrophages to the area, reducing erythema, pruritus, and edema.
動物種別の用量
- Focal or multifocal pruritic/inflammatory lesions · Initially used sparingly 1-4 times per day and then frequency is tapered when control is achieved. Shampoos: once a day to once a week (leave on 10 mins). · topical · q6-24h · < 2 months
- Focal or multifocal pruritic/inflammatory lesions · Initially used sparingly 1-4 times per day and then frequency is tapered when control is achieved. Shampoos: once a day to once a week (leave on 10 mins). · topical · q6-24h · < 2 months
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
- Tuberculosis of the skin
- Pregnancy (relative contraindication)
- Pregnant animals
- Renal disease (systemic use generally contraindicated)
- Diabetes mellitus (systemic use generally contraindicated)
有害事象
- Skin atrophy (with long-term use)
- Skin fragility
- Superficial follicular cysts (milia)
- Comedones
- HPA axis suppression (rare, but possible with long-term use)
- Weight loss (catabolic effect)
- Cutaneous atrophy
- Iatrogenic hyperadrenocorticism (PU/PD, elevated liver enzymes)
- Vomiting
- Diarrhoea
- Gastrointestinal ulceration
- Increased urine glucose levels
- Decreased serum T3 and T4 values
- Hypothalamic-pituitary axis suppression (with prolonged use)
- Adrenal atrophy
- Impaired wound healing
薬物相互作用
- NSAIDs · Increased risk of gastrointestinal ulceration · major
- Insulin · Glucocorticoids antagonize the effect of insulin · major
- Phenobarbital · May accelerate the metabolism of corticosteroids · moderate
- Itraconazole · May decrease the metabolism of corticosteroids · moderate
- Acetazolamide · Increased risk of hypokalaemia · moderate
- Amphotericin B · Increased risk of hypokalaemia · major
- Furosemide · Increased risk of hypokalaemia · moderate
- Thiazide diuretics · Increased risk of hypokalaemia · moderate
モニタリング
- Resolution of clinical signs (pruritus, erythema)
- Signs of skin atrophy or secondary infection
- Serum electrolytes (especially Sodium and Potassium)
- Liver enzymes
- Blood and urine glucose
- Clinical signs of GI ulceration
- Thyroid panel (T3, T4) if indicated
過量投与
Overdose via topical application is unlikely, but chronic overuse can lead to iatrogenic hyperadrenocorticism (Cushing's syndrome) and HPA axis suppression.
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。