次水楊酸鉍
次水楊酸鉍是一種非處方胃腸道保護劑和止瀉藥。在獸醫學中，主要用於控制急性分泌性腹瀉，並作為根除幽門螺旋桿菌（*Helicobacter*）胃腸道感染的「三合一療法」成分之一。 **臨床重點：** - 母體化合物在胃腸道中會被裂解，釋放出**水楊酸**。 - **貓咪需謹慎使用：** 由於貓缺乏葡萄糖醛酸結合代謝途徑，對水楊酸高度敏感。高劑量或重複給藥極易引起水楊酸中毒。 - 具有放射線不透性，可能會干擾胃腸道X光檢查。 - 飼主常將鉍劑引起的無害黑色糞便誤認為黑便（胃腸道出血）。
作用機制: Bismuth subsalicylate is cleaved in the small intestine into **bismuth carbonate** and **salicylate**. - **Bismuth component:** Provides physical mucosal protection, binds bacterial endotoxins, and exhibits weak antibacterial properties (which contributes to its efficacy against *Helicobacter* spp.). - **Salicylate component:** Inhibits **cyclooxygenase (COX)** enzymes → decreases **prostaglandin** synthesis → reduces intestinal inflammation and hypersecretion, effectively mitigating clinical signs of secretory diarrhea.
各物種劑量
- For diarrhea · 0.25 mL/kg · PO · q4-6h · Cats are sensitive to salicylates and probably should not receive frequent or high dosages
- For diarrhea · 0.5-1 mL/kg · PO · q12h · 3 days · Using 'Pepto-Bismol Regular' or equivalent strength (17.5 mg/mL) liquid
- For diarrhea in kittens and young cats · 1-2 mL · PO · 3-4 times a day · Refrigeration may increase palatability
- For eliminating Helicobacter gastritis infections (triple therapy) · 0.22 mL/kg · PO · q4-6h · 3 weeks · Given with Metronidazole 15.4 mg/kg q8h and amoxicillin 11 mg/kg q8h
- For eliminating Helicobacter gastritis infections (triple therapy) · 7.5 mg/kg · PO · q8h · 3-4 weeks · Given with Metronidazole 20 mg/kg and amoxicillin 30 mg/kg
- For eliminating Helicobacter gastritis infections (triple therapy) · 17.5 mg/kg · PO · q8h · 21 days · Given with Metronidazole 20 mg/kg PO q12h, amoxicillin 20 mg/kg PO q12h, famotidine 0.5 mg/kg PO once daily, and sucralfate 25 mg/kg PO q8h
- For diarrhea in calves · 60 mL · PO · two to four times a day · two days
- For diarrhea · 2-3 ounces · PO · 2-4 times a day
- For diarrhea in foals · 3-4 ounces per 45 kg (100 lb.) body weight · PO · q6-8h
- For diarrhea in foals or adults · 1 ounce per 8 kg of body weight · PO · 3-4 times daily
- For diarrhea in foals · 3-4 oz. · PO · q6-8h
- For diarrhea in foals · 60 mL · PO · two to four times a day · two days
- For diarrhea in baby pigs · 2-5 mL · PO · two to four times a day · 2 days
- For acute diarrhea · 1 mL per 5 kg of body weight · PO · 3 times a day · should probably not exceed 5 days of therapy · Dose based on 17.5 mg/mL liquid
- For acute diarrhea · 0.25 mL/kg up to 2 mL/kg · PO · q4-6h (0.25 mL/kg) or q6-8h (2 mL/kg) · Pepto-Bismol
- For treating Helicobacter gastritis infections (triple therapy) · 0.22 mL/kg · PO · q4-6h · 3 weeks · Given with Metronidazole 15.4 mg/kg q8h and amoxicillin 11 mg/kg q8h
- For treating Helicobacter gastritis infections (triple therapy) · 262 mg tablets given based upon body weight (<5kg = 0.25 tablet; 5-9.9 kg = 0.5 tablet; 10-24.9kg = 1 tablet; >25kg = 2 tablets) · PO · q12h · 2 weeks · Given with Metronidazole 10 mg/kg PO q12h and amoxicillin 15 mg/kg q12h
- As a gastroprotectant/coating agent in the adjunctive treatment of uremic gastritis · 2 mL/kg · PO · q6-8h
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
- Pre-existing bleeding disorders
- Known hypersensitivity to salicylates
- Use with extreme caution, if at all, in cats
不良反應
- Constipation or fecal impaction (especially in infants or debilitated patients)
- Stool discoloration (gray-black or greenish-black)
- Salicylism / salicylate toxicity (especially in cats or at high doses)
藥物相互作用
- Tetracycline · Bismuth can decrease the absorption of orally administered tetracyclines. Separate administration by at least 2 hours and give tetracycline first.
- Aspirin · Concomitant administration may increase salicylate serum levels, increasing the risk of toxicity.
監測
- Clinical efficacy (resolution of diarrhea)
- Fluid and electrolyte status in severe diarrhea
- Signs of salicylate toxicity (especially in cats)
過量
Bismuth subsalicylate liquid/suspension contains approximately **8.7 mg/mL salicylate**. > **Note:** Two tablespoonsful (30 mL) is approximately equivalent to one 325 mg aspirin tablet. High doses can lead to **salicylism** (salicylate toxicity), which may manifest as gastrointestinal ulceration, bleeding, acid-base disturbances, and neurological signs. Cats are particularly vulnerable to overdose due to their deficient glucuronidation metabolism.
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。