Ammonium Chloride

**Ammonium chloride** is a systemic and urinary acidifying agent used in veterinary medicine. * **Primary Uses:** Helps prevent and dissolve certain types of uroliths (e.g., struvite), enhances renal excretion of specific toxins (e.g., strontium, strychnine) or drugs (e.g., quinidine), and improves the efficacy of certain antimicrobials (like penicillins and tetracyclines) in the urinary tract. * **Metabolic Alkalosis:** Can be administered intravenously for the rapid correction of severe metabolic alkalosis. * **Clinical Pearl:** Due to the advent of highly effective struvite-dissolution diets (which inherently cause aciduria), ammonium chloride is now rarely recommended for feline struvite management. It remains a staple for urolith prevention in small ruminants, though dietary roughage-to-concentrate ratios can heavily influence its efficacy.

กลไกการออกฤทธิ์: Ammonium chloride induces acidification through hepatic metabolism: * **Dissociation:** In vivo, it dissociates into **chloride** and **ammonium** ions. * **Hepatic Conversion:** The liver converts the ammonium cation to urea, releasing a **hydrogen ion (H⁺)**. * **Acidification Pathway:** H⁺ combines with bicarbonate → H₂O + CO₂. This depletes extracellular alkaline reserves, decreasing serum bicarbonate and lowering both blood and urine pH. * **Renal Excretion:** Excess chloride ions exceed tubular reabsorption capacity and are excreted alongside cations (mainly sodium) and water, causing a mild, transient **diuretic effect**.

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