氫可酮
氫可酮是一種菲衍生物**鴉片類促效劑**，在獸醫學中主要用作犬隻的強效**鎮咳藥**。 * **主要適應症：** 治療與氣管塌陷、支氣管炎或犬傳染性氣管支氣管炎（犬舍咳）相關的嚴重、乾性、無痰咳嗽。 * **行為治療：** 偶爾用於治療與鴉片類相關的行為問題（如舔舐肉芽腫、刻板行為），藉由提供外源性鴉片類物質來減少自我刺激行為。 * **鎮痛作用：** 含有對乙醯氨基酚（普拿疼成分）的複方產品可用於犬隻的中度口服鎮痛。 > **嚴重警告：** 含有對乙醯氨基酚的複方產品（如 Vicodin®、Lortab®）**絕對禁止用於貓咪**，因為會導致致命的對乙醯氨基酚中毒。
作用機制: Hydrocodone acts primarily by binding to **mu-opioid receptors** in the central nervous system. * **Antitussive Effect:** Direct suppression of the cough reflex at the **cough center** in the **medulla oblongata**. * **Analgesic Effect:** Binds to pre- and post-synaptic **mu-receptors** in the brain and spinal cord → inhibits release of nociceptive neurotransmitters (like Substance P) → hyperpolarizes neurons → decreases excitability and pain transmission. * **Respiratory Effects:** Tends to have a drying effect on respiratory mucosa, increasing the viscosity of secretions. The addition of homatropine methylbromide (an anticholinergic) in some formulations enhances this drying effect.
各物種劑量
- For adjunctive treatment of opioid-related stereotypies · 1.25-5 mg per cat PO q12h · PO · q12h · Do NOT use any product that contains acetaminophen.
- For cough · 0.22 mg/kg PO q6-12h · PO · q6-12h · Goal is to suppress coughing without causing excessive sedation
- As an analgesic using fixed dose combination products with acetaminophen · 0.22-0.5 mg/kg of the hydrocodone component PO q8-12h · PO · q8-12h · Do not exceed 15 mg/kg of the acetaminophen component q8h.
- For cough using Hycodan (or equivalent) · ¼ to 1 tablet (5 mg) once to 4 times daily · PO · q6-24h · In small and medium sized dogs.
- For lick granulomas · 5-10 mg (1-2 tablets) per 20 kg of body weight PO three times daily · PO · TID
- For adjunctive treatment of opioid-related stereotypies, lick granuloma · 0.22-0.25 mg/kg PO q8-12h · PO · q8-12h · Supplies exogenous opioids to decrease the need for self-stimulation.
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
- Hypersensitivity to narcotic analgesics
- Patients receiving monoamine oxidase inhibitors (MAOIs, e.g., selegiline)
- Diarrhea caused by toxic ingestion (until toxin is eliminated)
- Acetaminophen-containing products MUST NOT be used in cats
不良反應
- Sedation
- Constipation (especially with chronic therapy)
- Vomiting
- Gastrointestinal disturbances
- Masking of clinical signs of underlying respiratory disease
藥物相互作用
- Acepromazine · May cause additive hypotension in dogs with collapsing trachea
- Anticholinergic Drugs · May cause additive anticholinergic effects
- Antidepressants (Tricyclic & MAOIs) · May potentiate the adverse effects associated with the antidepressant
- CNS Depressants (anesthetics, antihistamines, phenothiazines, barbiturates, tranquilizers) · May cause increased CNS or respiratory depression
監測
- Clinical efficacy (reduction in cough frequency/severity, pain relief)
- Adverse effects (excessive sedation, constipation, respiratory depression)
過量
Massive overdose primarily causes **CNS, cardiovascular, and respiratory depression** secondary to opiate effects. * **Treatment:** If ingestion was recent, empty the gut using standard protocols. Administer **naloxone** to reverse opioid effects as necessary. * **Note on Homatropine:** The homatropine ingredient in some formulations may cause anticholinergic effects, but its relatively low toxicity usually does not require specific treatment.
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。