右美托咪啶
Detomidine
Imidazoline derivative alpha2-adrenergic agonist
別名: Dormosedan · demotidini hydrochloridum · MPV 253-AII
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
經審核的 v13 劑量證據
經審核的非計算證據經審核的非計算證據 (1)
只供證據參考，不會自動計算
Injection
• Injection: Detomidine 0.02 – 0.04 mg/kg IV or IM; allow animal to rest quietly prior to and after injection. Effects generally occur within 2 to 4 minutes of administration. Lower dose will generally provide 30 to 90 minutes of sedation. The higher dose will generally provide 90 to 120 minutes of sedation.
必須同時考慮的臨床上下文 (3)
- CAUTION: Do not confuse µg/kg or mg/m 2 with mg/kg doses.
- Detomidine HCl for injection should be stored at room temperature, 15°C to 30°C (59°F-85°F) and protected from light.
- Detomidine gel for sublingual administration should be stored at controlled room temperature, 20°C to 25°C (68°F-77°F); excursions are permitted from 15°C to 30°C (59°F-85°F).
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。
概覽
右美托咪啶 (Detomidine) 是一種強效的 α-2 腎上腺素受體激動劑，主要在馬匹醫學中用於提供深度的鎮靜與鎮痛效果。
- 效力： 其效力約為甲苯噻嗪 (Xylazine) 的 50 到 100 倍。
- 臨床應用： 廣泛用於馬匹的站立鎮靜、小型外科手術及鎮痛（特別是疝痛）。也曾標示外用於牛、小型反芻動物、駱駝科動物及鳥類。
- 重要注意事項： 即使馬匹看起來已深度鎮靜，仍可能對外界刺激產生突然反應（例如踢腿）。併用鴉片類藥物（如布托啡諾）有助於緩和這種驚嚇反應並提升鎮靜品質。
作用機制
Detomidine acts as a potent and highly specific agonist at alpha-2 adrenergic receptors in the central and peripheral nervous systems.
- Sedation & Analgesia: Activation of presynaptic alpha-2 receptors in the locus coeruleus and dorsal horn of the spinal cord → inhibition of norepinephrine release → decreased sympathetic outflow, resulting in profound sedation, muscle relaxation, and analgesia.
- Cardiovascular Effects: Initial activation of peripheral postsynaptic alpha-2 receptors → transient vasoconstriction and hypertension → compensatory vagal reflex → profound bradycardia and potential AV block. Central sympatholytic effects then lead to a prolonged decrease in blood pressure.
安全性與警告
禁忌症
- Preexisting AV or SA heart block
- Severe coronary insufficiency
- Cerebrovascular disease
- Severe respiratory disease
- Chronic renal failure
不良反應
- Initial blood pressure increase (hypertension)
- Profound bradycardia and heart block (AV block)
- Piloerection
- Sweating
- Ataxia
- Salivation
- Slight muscle tremors
- Penile prolapse
- Decreased gastrointestinal motility
注意事項
Clinical Precautions:
- Shock & Organ Dysfunction: Use cautiously in animals with endotoxic/traumatic shock, or advanced hepatic/renal disease.
- Stress Factors: Administer carefully to horses stressed by temperature extremes, fatigue, or high altitude. Consider lower doses in summer heat.
- Gastrointestinal: Inhibits GI motility; use with prudence in patients treated for intestinal impactions. May mask abdominal pain in colic cases, complicating diagnosis.
- Safety: Wear impermeable gloves when administering the sublingual gel to avoid human exposure.
藥物相互作用
Not recommended to be used together as effects may be additive.
Effects may be additive; dosage reduction required. Increased risk for arrhythmias with thiopental, ketamine, or halothane.
Do not use to treat cardiac effects caused by detomidine, as epinephrine possesses alpha agonist effects.
Severe hypotension can result.
Fatal dysrhythmias may occur if used with intravenous potentiated sulfonamides.
監測
- Level of sedation and analgesia
- Cardiac rate and rhythm
- Blood pressure (if indicated)
藥物動力學
半衰期
吸收
Well absorbed after oral administration, but currently used primarily parenterally. Oromucosal gel bioavailability is 22% vs 38% for IM.
分佈
Rapidly distributed into tissues, including the brain. Volume of distribution in horses: 0.47-0.59 L/kg (at rest), 1.3 L/kg (after exercise).
代謝
Extensively metabolized.
排除
Excreted primarily into the urine. Clearance: 12-16 mL/min/kg.
過量
Toxicity Profile:
- Tolerated by horses at 5X the high dose level (0.2 mg/kg).
- Doses of 10-40X recommended can cause severe respiratory and cardiovascular changes that can become irreversible and cause death.
- Reversal: Alpha-2 antagonists such as atipamezole (50-100 micrograms/kg) or yohimbine can be successfully used to reverse some or all effects of inadvertent overdoses.
可用產品
劑型
- Injection (10 mg/mL)
- Oromucosal Sublingual Gel (7.8 mg/mL)
獸醫用
- Detomidine HCl for Injection: 10 mg/mL (Dormosedan)
- Detomidine HCL Oromucosal Gel: 7.8 mg/mL (Dormosedan Gel)
各地核准狀態
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儲存與穩定性
Injection should be stored at room temperature (59-85°F; 15-30°C) and protected from light. Gel should be stored at controlled room temperature (68-77°F; 20-25°C).
飼主須知
飼主重要指引：
- 本藥物為強效鎮靜劑，應由熟悉其特性的專業人員在受監督的環境下使用。
- 即使您的馬匹看起來睡得很熟，如果被巨大的聲音或觸摸驚嚇，牠們仍然可能突然做出反應並踢人。接近鎮靜中的馬匹時請務必小心。
- 如果在獸醫指示下於家中給予口腔凝膠，請戴上防滲透手套，以防止藥物透過您的皮膚吸收。
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