Sodium Stibogluconate
**Sodium stibogluconate** is a pentavalent antimonial compound primarily utilized as an **antileishmanial** agent in both human and veterinary medicine. * It is considered a traditional mainstay for the treatment of both cutaneous and visceral leishmaniasis in dogs. * The drug is known for having a narrow therapeutic index, with a high potential for serious adverse effects. > **Clinical Pearl:** In the United States, this drug is not commercially available. It must be obtained directly from the Centers for Disease Control and Prevention (CDC) under specific protocols, and it may or may not be released for use in domestic animals.
กลไกการออกฤทธิ์: 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.
ขนาดยาตามชนิดสัตว์
- 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.
ขนาดยาเป็นข้อมูลอ้างอิงทางคลินิกสำหรับสัตวแพทย์ผู้มีใบอนุญาต โปรดตรวจสอบกับฉลากล่าสุดและผู้ป่วยแต่ละรายเสมอ
วิธีการให้ยา
ข้อห้ามใช้
- Pre-existing cardiac arrhythmias
- Significantly impaired renal function
- Previous serious adverse reaction to a dose of stibogluconate
- Severe renal impairment
- Severe hepatic impairment
อาการไม่พึงประสงค์
- 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
อันตรกิริยาระหว่างยา
- Amphotericin B · Increased risk of nephrotoxicity · major
- Allopurinol · Synergistic antileishmanial effect (often used together clinically) · minor
การติดตาม
- 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)
การได้รับยาเกินขนาด
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.
ข้อมูลอ้างอิงยาของ VetSheet มีไว้สำหรับสัตวแพทย์ผู้มีใบอนุญาตเพื่อช่วยในการตัดสินใจทางคลินิก ไม่ใช่สิ่งทดแทนการวินิจฉัยของผู้เชี่ยวชาญหรือฉลากล่าสุดของผู้ผลิต