葡萄糖胺 / 軟骨素
葡萄糖胺和軟骨素是廣泛使用的**營養補充品（保健食品）**，主要用於狗、貓和馬的**骨關節炎**及其他疼痛性關節疾病的輔助治療。由於泌尿道保護層中含有糖胺聚糖，它們有時也用於支持患有**貓下泌尿道疾病 (FLUTD)** 的貓咪的膀胱健康。 > **臨床要點：** 由於這些產品不受 FDA 作為藥物的監管，不同製造商的產品質量、純度和生物利用度可能存在巨大差異。強烈建議使用經過獨立質量測試和臨床試驗的知名獸醫公司產品（例如 Cosequin®）。 儘管臨床療效有時存在爭議且缺乏大規模的決定性研究，但這些補充劑通常被認為非常安全，並經常作為關節健康和慢性疼痛管理多模式方法的一部分。
作用機制: These compounds work synergistically to support cartilage matrix synthesis and inhibit cartilage degradation: * **Glucosamine:** Acts as a primary building block for cartilage. Chondrocytes utilize glucosamine to synthesize **glycosaminoglycans (GAGs)** and **hyaluronan**. It also regulates the synthesis of collagen and proteoglycans and exhibits mild anti-inflammatory properties by scavenging free radicals. * **Chondroitin Sulfate:** Provides structural integrity to cartilage. It actively **inhibits destructive enzymes** (such as metalloproteinases) in joint fluid and cartilage. It also stimulates the production of GAGs and proteoglycans, and may reduce thrombi formation in the microvasculature of the joint. **Pathway:** Exogenous Glucosamine + Chondroitin → Uptake by Chondrocytes → ↑ GAG & Hyaluronan Synthesis + ↓ Cartilage Degrading Enzymes → Improved Joint Fluid Viscosity & Cartilage Health.
各物種劑量
- Adjunctive treatment of cancer pain · 15-30 mg/kg (of the chondroitin component) PO once daily (q24h) for 4-6 weeks then half the dose · PO · q24h · 4-6 weeks then half dose
- Adjunctive treatment of chronic pain · 15-20 mg/kg (of the chondroitin component) PO once daily or every other day (q24-48h) · PO · q24-48h
- Dietary Supplement (Cosequin For Cats) · Initially: under 10 lb.: 1 capsule sprinkled on food daily; over 10 lb.: 2 capsules sprinkled on food daily (1 in AM/1 in PM). Maintenance Administration (after initial 4-6 week period): once desired response is obtained, capsules may be administered every other day. · PO · q24h or divided · Initial 4-6 weeks, then maintenance
- Navicular syndrome · 16.5 grams (5 scoops) in feed twice daily · PO · q12h · Using Cosequin Concentrated Powder
- Dietary Supplement (Cosequin Concentrated Powder) · Initially: for horses under 600 lb., 2 scoops in AM and 2 scoops in PM; horses 600-1,200 lb., 3 scoops in AM and 3 scoops in PM; horses over 1,200 lb., 4 scoops in AM and 4 scoops in PM. Suggested Maintenance Administration: horses under 600 lb., 1 scoop daily; horses 600-1,200 lb., 1-2 scoops daily; horses over 1,200 lb., 2 scoops daily. · PO · Divided AM/PM · Initial 2-4 weeks, then maintenance · Transition Period: Do not lower amount until horse has begun to respond. Reduce total daily amount by one level scoop each week.
- Adjunctive treatment of chronic pain · 13-15 mg/kg (of the chondroitin component) PO once daily (q24h) · PO · q24h
給藥途徑
禁忌症
- Known hypersensitivity to glucosamine or chondroitin
不良反應
- Mild gastrointestinal upset
- Flatulence
- Stool softening or mild diarrhea
- Hypersensitivity reactions (rare, as products are derived from natural sources)
藥物相互作用
- Doxorubicin · Glucosamine may induce resistance to this agent by reducing its inhibition of topoisomerase II.
- Etoposide · Glucosamine may induce resistance to this agent by reducing its inhibition of topoisomerase II.
- Warfarin · High doses of chondroitin/glucosamine may enhance coagulation effects and theoretically increase the International Normalized Ratio (INR).
- Heparin · High doses potentially could enhance the effects of heparin or other drugs that affect coagulation.
監測
- Clinical efficacy (improvement in mobility, reduction in pain, or improvement in urinary signs for FLUTD)
過量
Oral overdosage is highly unlikely to cause significant systemic problems. The LD50 for the combined compound in rats is greater than 5 g/kg. * **Clinical Signs:** Massive ingestions may result in gastrointestinal effects (vomiting, diarrhea). Theoretical changes in coagulation parameters could occur but have not been documented. * **Toxicity Note:** Products containing manganese could lead to manganese toxicity if given in very high dosages chronically above label recommendations.
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