右泛醇 (Dexpanthenol)
右泛醇（又稱 d-Panthenol）是**泛酸（維生素B5）**的醇類衍生物。 * **主要用途：** 營養補充（常包含於腸胃外維生素複合物中）及局部傷口癒合。 * **歷史用途：** 曾作為溫和的胃腸促動力藥，用於刺激腸道蠕動（例如治療麻痺性腸梗阻、術後腸無力或馬疝痛），儘管其促動力療效在現代獸醫學中尚有高度爭議。 > **臨床要點：** 雖然在治療胃腸道停滯方面，它已在很大程度上被更有效且具針對性的促動力藥（如 metoclopramide、cisapride 或 lidocaine 恆速靜脈輸注）所取代，但由於其極佳的安全性及在細胞代謝中的作用，它仍然是靜脈輸液維生素添加劑和局部皮膚製劑中的常見成分。
作用機制: Dexpanthenol acts as a precursor and is rapidly converted to **pantothenic acid** in vivo. * Pantothenic acid is a fundamental component of **Coenzyme A (CoA)**. * CoA facilitates critical acetylation reactions → essential for the synthesis of the neurotransmitter **acetylcholine (ACh)**. * Increased ACh availability → enhances parasympathetic tone → stimulates gastrointestinal smooth muscle contraction and peristalsis. * In topical applications, it promotes epithelialization and granulation tissue formation.
給藥途徑
禁忌症
- Mechanical gastrointestinal obstruction
- Hemophilia
- Concurrent use with depolarizing muscle relaxants (e.g., succinylcholine)
不良反應
- Hypersensitivity reactions (rare)
- Mild gastrointestinal distress (cramping, diarrhea)
- Prolonged bleeding time (very rare)
藥物相互作用
- Succinylcholine · Dexpanthenol may prolong the muscle relaxant effects of succinylcholine. Administration should be separated by at least 1 hour.
- Parasympathomimetics (e.g., bethanechol, neostigmine) · May have additive effects on gastrointestinal motility and parasympathetic tone.
監測
- Clinical signs of gastrointestinal motility (auscultation of bowel sounds)
- Resolution of ileus
- Fecal output
過量
Toxicity is extremely low. Massive overdose may cause mild gastrointestinal distress, cramping, or diarrhea. Treatment is largely supportive and symptomatic.
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