3% 過酸化水素 (オキシドール)
3%過酸化水素は広く利用されている局所消毒薬であり、獣医療においては主に犬の**緊急経口催吐薬**として頻繁に使用されます。 * **臨床のポイント:** 家庭の常備薬ですが、催吐薬としての使用は通常、すぐに獣医師の診察を受けられず、迅速な除染が必要な状況に限られます。臨床現場では、有効性が高く重度の粘膜刺激リスクが低い、**アポモルヒネ**（犬用）や**キシラジン/デクスメデトミジン**（猫用）などの中枢性催吐薬が推奨されます。 * **猫への注意:** 重度の壊死性出血性胃炎を引き起こすリスクが高いため、毒物学者は猫への使用を推奨していません。 * **有効性:** 催吐に成功しても、胃の内容物が完全に空になったとは限りません。摂取した薬物や毒素のかなりの量が残っているか、すでに吸収されている可能性があります。
作用機序: Orally administered hydrogen peroxide (3%) induces a vomiting reflex via direct irritant effects on the oropharynx and gastric lining. * **Mechanism:** H₂O₂ interacts with the enzyme **catalase** present in tissue and blood → rapid release of water (H₂O) and oxygen gas (O₂) → massive bubbling and gastric distension. * The combination of direct mucosal irritation and sudden gastric distension stimulates visceral afferent vagal and sympathetic nerves → signals the **emetic center** in the medulla oblongata → triggers the vomiting reflex. * Emesis typically ensues within 10 minutes of administration.
動物種別の用量
- As an emetic · 1 teaspoon (5 mL) per 5 lbs. (2.3 kg) of body weight (approximately 2 mL/kg) not to exceed 3 tablespoons (45 mL). · PO · can be repeated once if not initially successful · Vomiting usually occurs within minutes. Note: Use in cats is generally discouraged due to risk of severe gastric ulceration.
- As an emetic · 1-2 mL/kg PO up to 2-3 times · PO · up to 2-3 times
- As an emetic · 1-5 mL/kg PO; generally not to exceed 50 mL for dogs and 10 mL for cats; may repeat one time if after 10 minutes emesis does not occur. · PO · may repeat one time if after 10 minutes emesis does not occur · Inducing emesis is most effective if administered after a small meal.
- As an emetic · 1 teaspoon (5 mL) per 5 lbs. (2.3 kg) of body weight (approximately 2 mL/kg) not to exceed 3 tablespoons (45 mL). · PO · can be repeated once if not initially successful · Vomiting usually occurs within minutes.
- As an emetic · 1-2 mL/kg PO up to 2-3 times · PO · up to 2-3 times
- As an emetic · 1-5 mL/kg PO; may repeat one time if after 10 minutes emesis does not occur. · PO · may repeat one time if after 10 minutes emesis does not occur · Inducing emesis is most effective if administered after a small meal.
- As an emetic (pot-bellied pigs) · 1 teaspoon (5 mL) per 5 lbs. (2.3 kg) of body weight (approximately 2 mL/kg) not to exceed 3 tablespoons (45 mL). · PO · can be repeated once if not initially successful · Vomiting usually occurs within minutes.
投与経路
禁忌
- Animals already vomiting
- Severely lethargic, comatose, or debilitated animals (e.g., respiratory distress, decreased swallowing reflex, bradycardia)
- Seizuring or hyperactive animals
- Recent abdominal surgery
- Megaesophagus
- Ingestion of corrosives/caustics (e.g., acids, alkalis)
- Ingestion of sharp objects
- Ingestion of bagged illicit drugs
- Ingestion of hydrocarbons or petroleum distillates
- Rodents or rabbits (incapable of vomiting)
有害事象
- Aspiration of hydrogen peroxide solution or stomach contents
- Vasovagal (bradycardic) response in animals with cardiovascular compromise
- Gastric ulceration (particularly in cats)
- Gastric-dilatation-volvulus (GDV) in dogs
薬物相互作用
- ACETYLCYSTEINE (oral) · Hydrogen peroxide can oxidize acetylcysteine in the gut; alternative emetics are preferred for acetaminophen overdoses.
- ANTIEMETICS (e.g., ondansetron, maropitant) · Preadministration or ingestion of these products may negate the emetic effects of hydrogen peroxide.
モニタリング
- Efficacy (emesis, signs associated with toxicity of the substance ingested, blood levels of toxicants if applicable)
- Heart rate and respiration rate
- Thoracic auscultation after emesis (to monitor for aspiration pneumonia)
過量投与
Hydrogen peroxide 3% solution is relatively non-toxic after oral ingestion, though it can cause gastric irritation, vomiting, and rarely gastric ulceration or GDV. > **DANGER:** Hydrogen peroxide in concentrations of **10% or greater** (such as hair bleach or industrial peroxide) can be very corrosive, causing severe burns to the oral and gastric mucosa, and can induce fatal oxygen emboli after oral ingestion.
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。