氟替卡松
皮質類固醇
氟替卡松是一種強效的合成糖皮質激素，主要透過吸入方式用於控制獸醫學中的慢性呼吸道發炎（如貓氣喘和犬慢性支氣管炎）。 **臨床提示：** 吸入給藥可將藥物直接送達呼吸道黏膜，大幅減少全身性吸收以及口服皮質類固醇常見的不良副作用。
作用機制: Binds to specific **glucocorticoid nuclear receptors** → alters gene transcription → suppresses multiple inflammatory pathways, decreasing the production of inflammatory cytokines and inhibiting inflammatory cells such as eosinophils and macrophages.
給藥途徑
Inhalational
禁忌症
- Status asthmaticus (not for acute bronchospasm relief)
- Untreated respiratory tract infections
- Known hypersensitivity to fluticasone
不良反應
- Pharyngeal candidiasis (rare)
- Mild systemic adrenal suppression (at very high doses)
- Coughing or gagging during administration
藥物相互作用
- Ketoconazole · May increase systemic fluticasone exposure by inhibiting CYP3A4 metabolism · moderate
- Itraconazole · May increase systemic fluticasone exposure by inhibiting CYP3A4 metabolism · moderate
監測
- Clinical signs of respiratory disease (coughing frequency, wheezing, respiratory rate and effort)
- Signs of systemic corticosteroid excess (PU/PD, polyphagia) if on high doses
過量
Systemic toxicity is highly unlikely with acute overdose due to poor oral bioavailability. Chronic massive overdose may lead to iatrogenic hyperadrenocorticism (Cushing's syndrome) or hypothalamic-pituitary-adrenal (HPA) axis suppression.
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。