パンクレリパーゼ
パンクレリパーゼは、主に豚の膵臓から抽出された消化酵素（リパーゼ、プロテアーゼ、アミラーゼ）の組み合わせです。**膵外分泌不全（EPI）**の治療の基礎となる薬です。EPIは、膵臓が十分な消化酵素を合成・分泌できず、重度の消化不良、多食にもかかわらず体重減少、および大量の脂肪便を引き起こす疾患です。 **臨床のポイント：** * EPIは、膵腺房萎縮のため、ジャーマン・シェパードやラフ・コリーなどの特定の犬種で特に多く見られます。 * 診断は通常、動物種特異的な**トリプシン様免疫反応（TLI）**アッセイによって確定されます。 * 非常に効果的ですが、約15％の犬は酵素補充だけでは十分な反応を示さず、腸内細菌叢の乱れ（抗生物質反応性腸症）の同時管理、食事の変更（高消化性、低繊維食など）、またはコバラミン（ビタミンB12）の補充が必要になる場合があります。
作用機序: Pancrelipase acts locally in the duodenum and jejunum to replace missing endogenous pancreatic enzymes, facilitating the breakdown of macronutrients into absorbable molecules: * **Lipase** hydrolyzes triglycerides → free fatty acids and monoglycerides. * **Protease** (including trypsin and chymotrypsin) cleaves peptide bonds in proteins → oligopeptides and free amino acids. * **Amylase** hydrolyzes complex carbohydrates (starches) → dextrins and simple sugars (maltose). These enzymes resolve maldigestion and secondary malabsorption, allowing the animal to properly absorb nutrients and gain weight.
動物種別の用量
- Pancreatic exocrine insufficiency · 0.5-0.75 teaspoonsful with each meal mixed with food · PO · with each meal · Mix with food thoroughly and allow it to stand for 15-20 minutes before feeding. Best results are usually obtained by feeding small meals frequently (at least 3 times per day).
- Pancreatic exocrine insufficiency · 1 teaspoonful of powder or finely crushed nonenteric-coated tablets to each of two meals of balanced feline ration · PO · with each meal (twice daily) · Cats that refuse to eat food treated with powder may be dosed with capsules filled with powder or crushed non-enteric coated tablets. Not necessary to incubate before feeding.
- Pancreatic exocrine insufficiency · 0.5 teaspoonsful of powder per meal · PO · with each meal
- Pancreatic exocrine insufficiency · Initially, one teaspoon per cat per meal · PO · with each meal · When clinical signs have resolved, gradually decrease to the lowest effective dose.
- Pancreatic exocrine insufficiency · 1/8 tsp per kg · PO · with meals · Mix with moistened feed or administer by gavage. Incubate with food for 15 minutes prior to gavage.
- Gastric trichobezoars (Rabbits) · 1 teaspoonful (5 mL) pancrelipase powder plus 3 teaspoonsful (15 mL) of yogurt; let stand for 15 minutes, then give 2-3 mL · PO · q12h · Questionable efficacy for removing 'hairballs', but might help dissolve the protein matrix surrounding hair.
投与経路
禁忌
- Hypersensitivity to pork proteins
有害事象
- GI distress (diarrhea, cramping, nausea) at high doses
- Oral or esophageal ulcers (from concentrated enzymes)
- Oral bleeding (reported in dogs)
薬物相互作用
- Antacids (magnesium hydroxide, calcium carbonate) · May diminish the effectiveness of pancrelipase
- Cimetidine (or other H2 antagonists) · May increase the amount of pancrelipase that reaches the duodenum
モニタリング
- Animal's weight
- Stool consistency and frequency
過量投与
Overdosage may cause diarrhea or other intestinal upset (cramping, nausea). The effects should be temporary; treat by reducing the dosage and providing supportive care if diarrhea is severe.
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。