吉非貝齊
吉非貝齊 (Gemfibrozil) 是一種屬於纖維酸類的口服**降血脂**藥物。 > **臨床重點：** 雖然主要用於人類醫學，但在獸醫學中，當飲食控制（超低脂飲食）無效時，它被標示外用於治療犬貓嚴重的的高三酸甘油酯血症（通常 >500 mg/dL）。迷你雪納瑞是容易患原發性高脂血症的典型犬種，可能需要此療法。 主要特點包括： - 作為嚴格限制飲食脂肪的**輔助療法**。 - 可能降低流感相關的死亡率（在小鼠模型中發現），並正在研究作為重症流感的輔助治療。 - 在獸醫學中的臨床經驗非常有限，其療效和安全性尚未完全確立。
作用機制: Gemfibrozil acts primarily as an agonist for the **Peroxisome Proliferator-Activated Receptor-alpha (PPAR-α)**. - **PPAR-α activation** → alters transcription of genes involved in lipid metabolism. - Increases **lipoprotein lipase (LPL)** activity → enhances clearance of triglyceride-rich lipoproteins. - Inhibits lipolysis in adipose tissue → reduces hepatic uptake of plasma free fatty acids → decreases hepatic production of triglycerides. - Inhibits the synthesis of **apolipoprotein B** (the primary carrier protein for VLDL) → reduces VLDL production and the incorporation of long-chain fatty acids into triglycerides.
各物種劑量
- Hypertriglyceridemia (not controlled with diet alone) · 7.5-10 mg/kg · PO · q12h
- Hypertriglyceridemia (not controlled with diet alone) · 10 mg/kg · PO · q12h
- Hypertriglyceridemia (not controlled with diet alone) · 150 mg-300 mg (total dose) · PO · q12h
- Hypertriglyceridemia (not controlled with diet alone) · 200 mg (total dose) · PO · once daily
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
- Severe hepatic dysfunction
- Severe renal dysfunction
- Known hypersensitivity to gemfibrozil
不良反應
- Abdominal pain
- Vomiting
- Diarrhea
- Abnormal liver function tests
- Dyspepsia (human)
- CNS effects: headache, somnolence, dizziness (human)
- Myositis (human)
- Bone marrow depression (rare, human)
藥物相互作用
- Thiazide diuretics · May possibly increase triglyceride concentrations
- Beta-blockers · May possibly increase triglyceride concentrations
- Estrogens · May possibly increase triglyceride concentrations
- Ursodiol · May reduce effectiveness of gemfibrozil
- Warfarin · Gemfibrozil may potentiate anticoagulant effects
監測
- Plasma triglycerides (realistic goal for therapy is 400 mg/dL or less)
- Baseline and periodic CBC
- Baseline and periodic liver function tests
- Adverse clinical effects (GI upset, behavior changes)
- Client adherence to prescribed diet and dosing schedule
過量
Limited veterinary information is available. The reported LD50 (oral) in rats is 1414 mg/kg. - **Treatment:** Consider gut-emptying protocols for recent large oral ingestions and provide supportive care as required. - **Monitoring:** Monitor for dehydration and electrolyte imbalance if vomiting and/or diarrhea is severe or persists. Monitor liver function tests.
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。