雙氯芬酸鈉
雙氯芬酸鈉是一種**非類固醇消炎止痛藥 (NSAID)**。 - **獸醫用途**：以局部脂質體乳膏（Surpass®）形式獲 FDA 批准用於馬匹，以控制與骨關節炎相關的局部關節疼痛和發炎。 - **全身性用途**：雖然理論上可全身性用於其他物種，但對於犬貓有更安全的 FDA 批准替代藥物。 > **重要毒性提示**：雙氯芬酸對鳥類（尤其是禿鷲）具有高度毒性，會導致致命的腎衰竭，絕不可用於鳥類。
作用機制: Diclofenac is a non-specific inhibitor of **cyclooxygenase (COX-1 and COX-2)** enzymes. - **Arachidonic Acid Cascade**: Inhibits the conversion of arachidonic acid → **prostaglandins** and **thromboxanes**. - **Lipooxygenase**: May also have some inhibitory effects on the lipooxygenase pathway, reducing leukotriene production. - **Result**: Decreased production of inflammatory mediators leads to reduced pain, hyperpyrexia, and inflammation.
各物種劑量
- Control of pain and inflammation associated with osteoarthritis in tarsal, carpal, metacarpophalangeal, metarsophalangeal, and proximal interphalangeal (hock, knee, fetlock, pastern) joints · Apply a five inch ribbon · topical · twice daily · up to 10 days · Wear rubber gloves and rub cream thoroughly into the hair covering the joint until cream disappears.
- Ocular inflammation / Uveitis · 1 drop per affected eye · topical · bid to qid · As directed by veterinarian · Standard veterinary ophthalmic dosing; not explicitly stated in the provided monograph.
- Ocular inflammation / Uveitis · 1 drop per affected eye · topical · bid to qid · As directed by veterinarian · Standard veterinary ophthalmic dosing; not explicitly stated in the provided monograph.
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
- Hypersensitivity to diclofenac or any component of the cream
- Horses less than one year old
- Birds (implicated in causing death in vultures)
不良反應
- Colic (horses)
- Weight loss
- Gastric ulcers
- Diarrhea
- Uterine discharge
- Local inflammation
- Swelling
- Alopecia
- Vomiting (dogs/cats)
- Bloody diarrhea/melena (dogs/cats)
- Polydipsia (dogs/cats)
藥物相互作用
- Topical Corticosteroids · Increased risk of delayed corneal healing and severe corneal complications (corneal melting) when used concurrently. · major
- Topical Prostaglandin Analogues (e.g., Latanoprost) · NSAIDs may theoretically blunt the intraocular pressure-lowering effect of prostaglandin analogues. · moderate
監測
- Efficacy (reduction in pain/inflammation)
- Adverse effects (GI signs, local skin reactions)
過量
As an NSAID, overdosage primarily affects the **gastrointestinal** and **renal** systems. - **Horses (Topical Overdose)**: Weight loss, gastric ulcers, colic, diarrhea, and uterine discharge. - **Dogs/Cats (Ingestion)**: Vomiting, diarrhea (often bloody/melena), and polydipsia. - **Treatment**: - **Decontamination**: Emetics and/or activated charcoal for recent ingestions. - **GI Protection**: Use of gastrointestinal protectants (e.g., sucralfate, omeprazole) is warranted if GI effects are expected. - **Renal Protection**: Fluid diuresis is warranted if renal effects are anticipated. - **Supportive Care**: Symptomatic treatment as needed.
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。