德拉昔布
德拉昔布 (Deracoxib) 是一種專為獸醫設計的**昔布類非類固醇消炎止痛藥 (NSAID)**。FDA 批准用於犬隻，以控制與**骨關節炎**相關的疼痛和發炎，以及**術後疼痛**管理。 * **臨床要點**：與吡羅昔康 (Piroxicam) 類似，由於膀胱移行細胞癌 (TCC) 會過度表現 COX-2，德拉昔布在輔助治療上具有潛力。 * 本藥具備高適口性（咀嚼錠），雖能提高服藥順從性，但也增加了意外過量攝入的風險，請務必妥善收納。
作用機制: Deracoxib is a **selective COX-2 inhibitor** (coxib). * **Arachidonic Acid Cascade**: It inhibits the **cyclooxygenase-2 (COX-2)** enzyme → decreases the synthesis of pro-inflammatory **prostaglandins** (e.g., PGE2) responsible for pain, inflammation, and fever. * At therapeutic doses, it largely spares **COX-1**, the constitutive enzyme responsible for maintaining normal gastrointestinal mucosal integrity, renal blood flow, and platelet function. * *Note*: COX-2 selectivity is dose-dependent. At higher doses, COX-1 inhibition occurs, increasing the risk of gastrointestinal and renal toxicity.
各物種劑量
- Control of pain and inflammation associated with osteoarthritis · 1-2 mg/kg PO once a day as needed · PO · q24h · Ongoing
- Treatment of post-operative pain · 3-4 mg/kg PO once a day as needed · PO · q24h · Not to exceed 7 days of therapy at this dosage
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
- Known hypersensitivity to deracoxib
不良反應
- Vomiting
- Anorexia/weight loss
- Diarrhea
- Melena
- Hematemesis
- Hematochezia
- GI ulceration/perforation
- Azotemia
- Polydipsia/polyuria
- Urinary tract infection (UTI)
- Hematuria
- Urinary incontinence
- Renal failure
- Anemia
- Thrombocytopenia
- Elevated hepatic enzymes
- Changes in total protein
藥物相互作用
- ACE Inhibitors (e.g., enalapril, benazepril) · NSAIDs can reduce effects on blood pressure. Concurrent use may increase the risk for renal injury due to reduced renal blood flow.
- Aspirin · May increase the risk of gastrointestinal toxicity (ulceration, bleeding, vomiting, diarrhea). A multi-day washout period is warranted when switching.
- Corticosteroids (e.g., prednisone) · May significantly increase the risk of gastrointestinal toxicity (ulceration, bleeding, vomiting, diarrhea).
- Digoxin · NSAIDs may increase serum levels of digoxin.
- Fluconazole · May increase plasma levels of deracoxib (extrapolated from human celecoxib data).
- Furosemide · NSAIDs may reduce saluretic and diuretic effects.
- Methotrexate · Serious toxicity has occurred when NSAIDs are used concomitantly; use with extreme caution.
- Nephrotoxic Drugs (e.g., aminoglycosides, amphotericin B) · May enhance the risk of developing nephrotoxicity.
- Other NSAIDs · May increase the risk of gastrointestinal toxicity (ulceration, bleeding, vomiting, diarrhea).
監測
- Baseline and periodic CBC and serum chemistry (including BUN/serum creatinine, and liver function assessment)
- Baseline history and physical
- Efficacy of therapy
- Adverse effect monitoring via client
過量
Acute toxicity data indicates non-linear elimination occurs in dogs at dosages of 10 mg/kg and above. * **10 mg/kg/day**: No clinically observable adverse effects in a 14-day study, though focal tubular necrosis was seen in 3 of 10 dogs in a 6-month safety study. * **25-100 mg/kg/day**: Dogs survived 10-11 days but showed vomiting and melena. * **Clinical Signs of Overdose**: Vomiting, diarrhea, lethargy, and elevated creatinine. > **Treatment**: Decontamination with emetics and/or activated charcoal is appropriate for acute ingestions. The ASPCA APCC recommends **GI protectants** at acute dosages of 15 mg/kg and above, and **IV fluid diuresis** at dosages of 30 mg/kg and above in healthy dogs. Monitor for GI erosion/ulceration and treat symptomatically.
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。