右旋糖酐鐵
右旋糖酐鐵是一種注射用補血劑，主要用於治療和預防**缺鐵性貧血**，特別是在新生食用動物（如仔豬）中。仔豬出生時鐵儲存量低，且在室內飼養時無法從土壤中獲取鐵質，因此早期補充鐵質對於預防貧血至關重要。 在小動物醫學中，右旋糖酐鐵常作為慢性腎病患者接受**紅血球生成素 (EPO)** 或達貝泊汀 (darbepoetin) 治療時的輔助療法，特別是當病患對口服鐵劑耐受性差或吸收不良時。 > **臨床要點：** 雖然補充鐵質可以改善因缺鐵引起的物理症狀和血紅素低下，但它本身並不能刺激紅血球生成，也無法糾正其他原因引起的貧血。
作用機制: Iron is an essential structural component of **hemoglobin** and **myoglobin**, facilitating oxygen transport and utilization throughout the body. It also acts as a critical cofactor for multiple metabolic enzymes. * **Pathway:** IM Injection → Slow absorption via lymphatic system → Phagocytosis by reticuloendothelial system (RES) in liver, spleen, and bone marrow → Cleavage of iron from dextran → Iron binds to **transferrin** for transport → Incorporation into **hemoglobin** in bone marrow or stored as **ferritin** and **hemosiderin**. * **Key Enzymes:** Ionized iron is a vital component of **cytochrome oxidase**, **succinic dehydrogenase**, and **xanthine oxidase**.
各物種劑量
- Prevention of transient neonatal iron deficiency anemia · 50 mg iron dextran injection at 18 days of age · IM · once
- Adjunctive therapy with erythropoietin treatment · 10 mg/kg IM every 3-4 weeks · IM · q3-4 weeks
- Adjunctive therapy with erythropoietin treatment in cats who cannot tolerate oral iron therapy · 50 mg IM q3-4 weeks · IM · q3-4 weeks
- General · 10 mg/kg IM once weekly · IM · weekly
- Iron deficiency anemia or following hemorrhage · 10 mg/kg IM; repeat in 7-10 days if PCV fails to return to normal · IM · once, repeat in 7-10 days if needed
- Iron deficiency anemia or following hemorrhage · 10 mg/kg IM; repeat weekly · IM · weekly
- Prevention of iron deficiency anemia in baby pigs (2-4 days of age) · Administer an initial intramuscular injection of 100 mg of elemental iron to each animal at 2 to 4 days of age. Dosage may be repeated in 14 to 21 days. · IM · once, repeat in 14-21 days
- Iron deficiency anemia · 10-20 mg/kg once, followed by oral therapy with ferrous sulfate · IM · once · Followed by oral therapy with ferrous sulfate
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給藥途徑
禁忌症
- Known hypersensitivity to iron dextran
- Any anemia other than iron deficiency anemia
- Acute renal infections
- Concurrent use with oral iron supplements
不良反應
- Prostration and muscular weakness (pigs)
- Anaphylactoid reactions (rarely fatal)
- Nausea, vomiting, and sudden death within 1 hour (in pigs born to Vitamin E/Selenium deficient sows)
- Muscle tissue staining at injection site (in pigs >4 weeks old)
- Injection site sarcomas (associated with large SC doses in laboratory animals)
藥物相互作用
- Chloramphenicol · May delay the response to iron administration; avoid using chloramphenicol in patients with iron deficiency anemia
監測
- CBC (Complete Blood Count)
- RBC indices (MCV, MCHC)
- Adverse reactions (especially post-injection anaphylaxis)
- Serum iron (Note: values may not be meaningful for up to 3 weeks post-injection)
過量
Inadvertent overdose injections may lead to iron toxicity, which can cause severe gastrointestinal mucosal damage, cardiovascular collapse, and liver failure. Depending on the size of the dose, chelation therapy may be required. **Deferoxamine** is the specific chelating agent used for severe iron toxicity.
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