スチボグルコン酸ナトリウム
スチボグルコン酸ナトリウムは、犬のリーシュマニア症の治療に使用される5価アンチモン化合物です。米国では市販されておらず、CDCを通じて入手可能です。重篤な副作用のリスクがあるため、慎重な投与が求められます。
作用機序: The exact mechanism of action of sodium stibogluconate remains incompletely elucidated. * **Prodrug Hypothesis:** It is widely hypothesized to act as a prodrug, where the pentavalent antimony (SbV) is reduced to the more toxic trivalent antimony (SbIII) within the host macrophage or the parasite itself. * **Bioenergetic Disruption:** It is believed to interfere with the parasite's bioenergetics by reducing **ATP and GTP synthesis** in susceptible *Leishmania* amastigotes, ultimately leading to parasite death.
動物種別の用量
- Treatment of cutaneous leishmaniasis · 30-50 mg/kg IV or SC daily · IV/SC · q24h · 3-4 weeks
- Treatment of visceral leishmaniasis · 30-50 mg/kg IV or SC q24h · IV/SC · q24h · one month · Has severe side effects and may not be obtainable in the USA; allopurinol alone is usually used initially.
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
- Pre-existing cardiac arrhythmias
- Significantly impaired renal function
- Previous serious adverse reaction to a dose of stibogluconate
- Severe renal impairment
- Severe hepatic impairment
有害事象
- Increased AST levels
- Pain on injection
- Musculoskeletal pain
- Hemolytic anemia
- Leukopenia
- Vomiting
- Diarrhea
- Pancreatitis
- Myocardial injury and arrhythmias
- Renal toxicity
- Shock
- Sudden death
- Thrombophlebitis (with IV administration)
- Nephrotoxicity
- Hepatotoxicity
- Injection site pain
- Lethargy
薬物相互作用
- Amphotericin B · Increased risk of nephrotoxicity · major
- Allopurinol · Synergistic antileishmanial effect (often used together clinically) · minor
モニタリング
- CBC
- Liver enzymes (especially AST)
- Renal function tests
- ECG (for myocardial injury/arrhythmias)
- Bone marrow cultures for Leishmania
- Clinical efficacy
- Renal function (BUN, Creatinine, SDMA, Urinalysis)
- Hepatic enzymes (ALT, AST, ALP)
- Pancreatic enzymes (cPLI, Lipase)
- ECG (for arrhythmias)
過量投与
In the unlikely event of a parenterally administered overdose, it is suggested to immediately contact an animal poison control center. * **Chelation Therapy:** Potentially, antimony toxicity can be managed by chelating agents such as **dimercaptosuccinic acid (DMSA)** or **d-penicillamine** to enhance excretion.
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。