氟氫可的松
氟氫可的松是一種具有強效鹽皮質激素活性和中度糖皮質激素活性的合成皮質類固醇。主要用於犬貓**腎上腺皮質機能減退症（愛迪生氏病）**的治療，特別是在無法使用核准的注射產品（特戊酸去氧皮質酮）時。 > **臨床警告：** 氟氫可的松的鹽皮質激素效力約為氫化可的松的125倍，糖皮質激素效力約為12倍（約為潑尼松龍的3倍）。在代謝或身體面臨壓力期間，可能仍需要額外補充潑尼松龍。
作用機制: Acts as an **aldosterone analogue** at the mineralocorticoid receptors in the distal convoluted tubule and collecting duct of the kidneys. * **Mineralocorticoid effect:** → Increases sodium (Na+) retention and potassium (K+) excretion. * **Glucocorticoid effect:** → Possesses roughly 3 times the glucocorticoid potency of prednisolone, contributing to anti-inflammatory and metabolic effects.
各物種劑量
- Hypoadrenocorticism (Addison's disease) · 0.01 mg/kg (starting dose); most stable patients require <0.05 mg/kg · PO · q12h (some may only require q24h) · Lifelong · Monitor absolute Na and K concentrations 4-6 hours post-pill. If on q24h dosing, check pre-pill concentrations as well.
- Hypoadrenocorticism (Addison's disease) · 0.01 mg/kg (starting dose); most stable patients require <0.05 mg/kg · PO · q12h · Lifelong · Doses as for dogs; very few reports in cats.
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
- No specific contraindications listed in the monograph, but use with caution in patients with congestive heart failure, severe hypertension, or renal disease.
- No specific contraindications available in the monograph, but generally contraindicated in patients with systemic fungal infections or known hypersensitivity.
不良反應
- Hypertension
- Oedema (including cerebral oedema)
- Hypokalaemia
- Hypercortisolism / Iatrogenic Cushing's syndrome (with long-term overdose)
- Polyuria/polydipsia (PU/PD)
- Clinical signs of hypercortisolism (with long-term overdose)
藥物相互作用
- Amphotericin B · Increased risk of severe hypokalaemia · major
- Furosemide · Increased risk of hypokalaemia due to additive potassium-depleting effects · moderate
- Thiazide diuretics · Increased risk of hypokalaemia due to additive potassium-depleting effects · moderate
監測
- Absolute serum sodium concentrations
- Absolute serum potassium concentrations
- Blood pressure
- Clinical signs of hypercortisolism or hypoadrenocorticism crisis
- Body weight and hydration status
- Absolute serum sodium concentrations (4-6 hours post-pill, and pre-pill if q24h)
- Absolute serum potassium concentrations (4-6 hours post-pill, and pre-pill if q24h)
- Clinical signs of hyperadrenocorticism or hypoadrenocorticism
過量
Overdosage can lead to **hypertension**, **oedema** (including cerebral oedema), and **hypokalaemia**. Long-term overdosage may result in clinical signs of **hypercortisolism** (iatrogenic Cushing's syndrome, e.g., PU/PD, polyphagia, alopecia, pot-bellied appearance). Treatment involves dose reduction and supportive care.
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。