雙氯芬胺

各物種劑量

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

• Significant hepatic disease (may precipitate hepatic coma)
• Renal or adrenocortical insufficiency
• Hyponatremia
• Hypokalemia
• Hyperchloremic acidosis
• Electrolyte imbalance
• Severe pulmonary obstruction (unable to increase alveolar ventilation)
• Hypersensitivity to carbonic anhydrase inhibitors
• Chronic, noncongestive, angle-closure glaucoma (long-term use)

不良反應

• Panting
• GI disturbances (inappetence, vomiting, diarrhea)
• CNS effects (sedation, depression, excitement)
• Hematologic effects (bone marrow depression)
• Renal effects (crystalluria, dysuria, renal colic, polyuria)
• Metabolic acidosis
• Hypokalemia
• Hyperglycemia
• Hyponatremia
• Hyperuricemia
• Hepatic insufficiency
• Dermatologic effects (rash)
• Hypersensitivity reactions

藥物相互作用

• Antidepressants, Tricyclic · Alkaline urine caused by dichlorphenamide may decrease excretion of tricyclic antidepressants.
• Aspirin (or other salicylates) · Increased risk of dichlorphenamide accumulation and toxicity; increased risk for metabolic acidosis; dichlorphenamide increases salicylate excretion.
• Digoxin · Dichlorphenamide may cause hypokalemia, leading to an increased risk for digoxin toxicity.
• Insulin · Rarely, carbonic anhydrase inhibitors interfere with the hypoglycemic effects of insulin.
• Methenamine compounds · Dichlorphenamide may negate the effects of methenamine in the urine due to alkalinization.
• Potassium-depleting drugs (corticosteroids, amphotericin B, corticotropin, diuretics) · Concomitant use may exacerbate potassium depletion.
• Phenobarbital · Increased urinary excretion, which may reduce phenobarbital levels.
• Primidone · Decreased primidone concentrations.
• Quinidine · Alkaline urine caused by dichlorphenamide may decrease quinidine excretion.

監測

• Intraocular pressure (IOP) / tonometry
• Serum electrolytes (may need to supplement potassium)
• Baseline CBC with differential and periodic retests if using chronically
• Clinical signs of adverse effects (GI upset, panting, CNS changes)

過量

Information regarding acute toxicity of dichlorphenamide is limited. * **Clinical Signs**: Likely extensions of adverse effects, including severe electrolyte derangements (hypokalemia, hyponatremia), profound metabolic acidosis, CNS depression, and dehydration. * **Treatment**: * Monitor serum electrolytes, blood gases, volume status, and CNS status. * Provide aggressive supportive care, including IV fluid therapy to correct dehydration and acid-base/electrolyte imbalances (e.g., potassium supplementation). Treat symptomatically.