高嶺土/果膠
高嶺土/果膠是一種口服胃腸道複方製劑，歷史上被用作止瀉劑和吸附劑。 * **高嶺土 (Kaolin)** 是一種天然存在的水合矽酸鋁，經粉碎和精製而成，幾乎不溶於水。 * **果膠 (Pectin)** 是一種主要由部分甲氧基化聚半乳糖醛酸組成的碳水化合物聚合物，提取自柑橘皮或蘋果渣。 **臨床要點與專家提示：** > **療效警告：** 高嶺土/果膠的臨床療效備受質疑。雖然它可能會改善糞便的稠度（使其不那麼水狀），但研究表明它並不能減少排便頻率、水分含量或整體重量。在現代獸醫學中，它在治療嚴重腹瀉方面已基本被淘汰。 > **毒性警報：** 許多以前含有高嶺土/果膠的人用非處方產品（例如 **Kaopectate®**）已經更改配方。在美國，Kaopectate® 現在含有**次水楊酸鉍 (bismuth subsalicylate)**，這是一種水楊酸鹽（類似阿斯匹靈）化合物，對貓具有高度毒性。在給藥前，務必確認非處方止瀉液的活性成分。
作用機制: Kaolin/pectin acts locally within the gastrointestinal tract through physical binding and coating mechanisms: * **Adsorption:** Kaolin physically binds (adsorbs) to bacteria, enterotoxins, and potentially other noxious substances in the gut lumen, preventing their systemic absorption or local mucosal damage. * **Mucosal Protection:** The viscous suspension coats the inflamed gastrointestinal mucosa, providing a physical barrier against irritation. * **pH Alteration:** The pectin component is broken down into **galacturonic acid** in the intestinal lumen → decreases the local pH, which may create a less favorable environment for certain pathogenic bacteria.
各物種劑量
- Diarrhea · 3-4 oz · PO · q2-3h
- Diarrhea · 1-2 mL/kg · PO · q2-6h
- Diarrhea · 1-2 mL/kg · PO · 3-4 times daily
- Diarrhea (Adults) · 4-10 fl. oz. · PO · every 2-4 hours · Until condition improves (max 48 hours without additional treatment)
- Diarrhea (Calves) · 2-3 fl. oz · PO · every 2-4 hours · Until condition improves (max 48 hours without additional treatment)
- Diarrhea · 2-4 quarts per 450 kg body weight · PO · twice daily
- Diarrhea · 1 oz. per 8 kg body weight · PO · 3-4 times a day
- Diarrhea in Foals · 3-4 oz · PO · q6-8h · Authors believe that bismuth subsalicylate is superior
- Diarrhea (Canary or parakeet) · 1 drop PO twice daily; or 1 and ½ dropperful placed in ⅔ oz. drinking water · PO · twice daily
給藥途徑
禁忌症
- Should not be used as the sole treatment for severe or chronic diarrhea
- Should not replace adequate fluid and electrolyte monitoring/replacement therapy
不良反應
- Transient constipation
- Fecal impaction (especially at high doses or in debilitated, very old, or very young patients)
- Increased fecal sodium loss (documented in rats)
藥物相互作用
- Digoxin · Kaolin/pectin may impair the oral absorption of digoxin. Separate doses by at least 2 hours.
- Lincomycin · Kaolin/pectin may inhibit the oral absorption of lincomycin. Administer kaolin/pectin at least 2 hours before or 3-4 hours after the lincomycin dose.
監測
- Clinical efficacy (resolution of diarrhea, improvement in stool consistency)
- Fluid and electrolyte status (especially in cases of severe or prolonged diarrhea)
過量
Overdosage is unlikely to cause any serious systemic effects since the ingredients are not absorbed. However, significant **constipation** or **fecal impaction** requiring medical treatment may occur.
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