希米考昔
希米考昔是一種非類固醇消炎止痛藥（NSAID），屬於考昔類，對COX-2酵素具有高度選擇性。在獸醫學中主要用於緩解犬隻骨關節炎相關的疼痛與發炎，以及骨科或軟組織手術的圍手術期疼痛管理。 > **警告：** 與所有NSAID一樣，存在胃腸道、腎臟和肝臟不良反應的風險。 **臨床提示：** 希米考昔製成適口性佳的咀嚼錠以提高服藥順從性，但必須嚴格放置於寵物無法觸及處，以防意外大量吞食造成過量。
作用機制: Cimicoxib **selectively inhibits the cyclooxygenase-2 (COX-2) enzyme**. → This limits the conversion of arachidonic acid to **prostaglandins** (such as PGE2) that mediate pain, inflammation, and fever. → By sparing the COX-1 enzyme at therapeutic doses, it aims to maintain normal physiological functions like gastric mucosal protection and renal blood flow, though selectivity is not absolute and adverse effects can still occur.
各物種劑量
- Osteoarthritis and perioperative pain due to orthopaedic or soft tissue surgery · Not specified in text · PO · Not specified · 3-7 days · Dose not explicitly stated in the provided snippet. Formulations available are 8 mg, 30 mg, and 80 mg.
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
- Dogs less than 10 weeks of age
- Dogs weighing less than 2 kg
- Gastrointestinal disorders or ulceration
- Impaired hepatic, cardiac, or renal function
- Bleeding disorders
- Pregnancy and lactation
- Hypersensitivity to NSAIDs or sulfonamides
不良反應
- Vomiting
- Diarrhea
- Anorexia
- Gastrointestinal ulceration
- Elevated liver enzymes
- Renal impairment
- Lethargy
藥物相互作用
- Corticosteroids · Increased risk of severe gastrointestinal ulceration and bleeding · major
- Other NSAIDs · Increased risk of gastrointestinal and renal toxicity · major
- ACE inhibitors · Increased risk of nephrotoxicity and reduced hypotensive effect · moderate
- Diuretics · Increased risk of nephrotoxicity · moderate
- Warfarin · Competition for plasma protein binding sites, potentially increasing bleeding risk · moderate
監測
- Renal function (BUN, Creatinine, SDMA, Urinalysis)
- Hepatic function (ALT, ALP, Bilirubin)
- Clinical signs of GI upset (vomiting, diarrhea, melena)
- Hydration status
過量
Overdose may lead to severe gastrointestinal signs (vomiting, bloody diarrhea, ulceration), renal failure, and hepatic damage. > **Treatment:** Discontinue the drug immediately. Initiate supportive care including intravenous fluid therapy to support renal perfusion, gastroprotectants (e.g., omeprazole, sucralfate), and closely monitor renal and hepatic blood parameters.
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。