氨基己酸
**氨基己酸 (EACA)** 是一種賴氨酸的合成衍生物。它作為**纖維蛋白溶解抑制劑**和**抗蛋白酶**。 * **歷史獸醫用途**：它曾被用作狗（特別是德國牧羊犬）**退化性脊髓神經病變 (DM)** 的輔助治療，儘管現代證據強烈質疑其對此疾病的療效。研究顯示沒有神經學上的改善，其用於 DM 很大程度上被認為是試驗性且無效的。 * **主要臨床用途**：其主要且具實證基礎的用途是治療**高纖維蛋白溶解引起的出血**。在獸醫學中，它越來越多地用於預防或治療嚴重的出血性疾病、創傷或手術出血（例如，易發生術後延遲出血的格雷伊獵犬）。 * **血小板低下症**：目前正持續評估其作為狗嚴重血小板低下症輔助治療以預防致命出血的用途，但安全性和療效仍在調查中。
作用機制: Aminocaproic acid is a lysine analog that competitively binds to the lysine-binding sites on **plasminogen**. * **Plasminogen** → (blocked by EACA) → Cannot bind to fibrin. * This prevents the conversion of plasminogen to **plasmin** by plasminogen activators. * At higher concentrations, it directly inhibits **plasmin** (antiplasmin activity), thereby preventing the breakdown of fibrin clots (**fibrinolysis**). * *In Degenerative Myelopathy*: It was theorized to exert **antiprotease activity**, reducing the activation of inflammatory enzymes that damage myelin, though clinical efficacy is lacking.
各物種劑量
- Adjunctive treatment of degenerative myelopathy (seen primarily in German shepherds) · 500 mg/dog · PO · q8h · indefinitely · Used in conjunction with acetylcysteine at 25 mg/kg PO q8h for 2 weeks, then q8h every other day. The 20% solution should be diluted to 5% with chicken broth or suitable diluent. Other treatments may include prednisone, Vitamin C, and Vitamin E. Note: No treatment has been shown to be effective in published trials.
- Antifibrinolytic · 50-100 mg/kg · IV or PO · q6h · No published doses for dogs, but has been used anecdotally.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
給藥途徑
禁忌症
- Active intravascular clotting (e.g., Disseminated Intravascular Coagulation - DIC)
不良反應
- GI irritation (vomiting, diarrhea) in ~1% of dogs
- Hyperkalemia (particularly in renal impaired patients)
藥物相互作用
- Estrogens · Hypercoagulation states may occur in patients receiving aminocaproic acid and estrogens concurrently.
監測
- Serum potassium (especially in patients with preexisting renal failure)
- Signs of bleeding or thrombosis
- Neurological status (if used for degenerative myelopathy)
過量
> **Toxicity**: The intravenous lethal dose in dogs is reportedly **2.3 g/kg**. * **Clinical Signs**: At lower IV overdosages, **tonic-clonic seizures** were noted in some dogs. * **Treatment**: There is no known specific antidote, but the drug is dialyzable. Treatment should consist of supportive care and seizure management (e.g., diazepam, midazolam) if necessary.
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。