多庫酯鈉 / 多庫酯鈣
**多庫酯 (Docusate)**（有鈉鹽或鈣鹽形式）是一種潤膚性瀉藥和**表面活性劑型糞便軟化劑**。 * **主要用途**：用於小動物以緩解便秘，特別是在排出堅硬糞便會引起疼痛或有害的情況下（例如：肛門直腸手術後、骨盆骨折）。 * **馬匹用途**：單獨使用或與礦物油結合使用，治療馬匹的大結腸糞便嵌塞。 * **臨床要點**：多庫酯不會顯著刺激胃腸道蠕動；相反，它促進糞便團塊軟化，使其更容易排出。
作用機制: Docusate acts primarily as an **anionic surfactant** (detergent). * **Surface Tension Reduction**: It lowers the surface tension of the stool → allows water and dietary fats to penetrate the ingesta and formed feces → softens the fecal mass. * **Secretory Effect**: In vivo studies show docusate increases **cAMP** concentrations in colonic mucosal cells → stimulates **ion secretion** (such as chloride) and increases fluid permeability from these cells into the colon lumen → further hydrates the stool.
各物種劑量
- Constipation · 50 mg · PO · per day · Docusate Sodium
- Constipation · 5-10 mL of Colace · Enema · as needed · Docusate Sodium
- Constipation · 50 mg · PO · as needed · Docusate Sodium
- Constipation · 1-2 pediatric suppositories · PR · as needed · Docusate Sodium
- Constipation · 50 mg · PO · q12-24h · Docusate Sodium
- Constipation · 50 mg · PO · once daily · Docusate Calcium
- Large colon impaction (to soften) · 6-12 g/500 kg diluted in 2-4 liters of water · Nasogastric tube · q12-24h
- Constipation · 50-100 mg (total dose) · PO · q12-24h · Docusate Sodium
- Constipation · 25 mg · PO · once to twice daily · Docusate Sodium; Small Dogs
- Constipation · 50 mg · PO · once to twice daily · Docusate Sodium; Medium/large Dogs
- Constipation · Two to three 50 mg capsules or one 240 mg capsule · PO · once daily · Docusate Calcium
- Constipation · One or two 50 mg capsules · PO · q12-24h · Docusate Calcium
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
- Pre-existing fluid or electrolyte abnormalities (use with caution)
不良反應
- Cramping
- Diarrhea
- Intestinal mucosal damage (especially at high doses)
- Throat irritation (liquid preparations)
- Bitter taste (can cause hypersalivation/foaming in cats)
藥物相互作用
- Mineral Oil · Theoretically enhances absorption of mineral oil. Not a significant concern in large animals, but concurrent use in dogs/cats is not recommended. If both are necessary in small animals, separate doses by at least 2 hours. · major
監測
- Clinical efficacy (resolution of constipation/impaction)
- Hydration status
- Electrolyte status (if indicated or in high doses)
過量
In **horses**, single doses of 0.65-1 g/kg have caused dehydration, intestinal mucosal damage, and death. Maximum therapeutic dosages of up to 0.2 g/kg have been reported. * **Clinical Signs (Horses)**: Begin 1-2 hours after dosing. Initial signs include restlessness and increased intestinal sounds, followed by increased respiratory and cardiac rates. Abdominal pain, watery diarrhea, and dehydration can occur, deteriorating over hours to days to lateral recumbency and death. * **Treatment**: Supportive care. Because of the secretory effects of high doses, hydration and electrolyte status must be monitored and corrected. GI protectants, bicarbonate, corticosteroids, and antiendotoxemic agents (NSAIDs) have been suggested as potentially helpful.
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。