美法侖
美法侖（Melphalan）是一種細胞毒性烷化劑，在獸醫腫瘤學中主要用於治療**多發性骨髓瘤**。它也可作為犬淋巴瘤救援方案中環磷醯胺的替代品，以及用於治療某些實體腫瘤（如卵巢癌、骨肉瘤、肺部和乳腺腫瘤）。 > **臨床警告：** 美法侖是一種強效細胞毒性藥物。必須嚴格遵守安全處理程序，以防止醫護人員和飼主意外接觸。
作用機制: Melphalan acts as a bifunctional alkylating agent. It forms **inter- and intrastrand cross-links** with DNA → alters DNA structure → **inhibits DNA synthesis and function**, ultimately leading to cell death (apoptosis), particularly in rapidly dividing neoplastic cells.
給藥途徑
禁忌症
- Bone marrow suppression
- Concurrent infection
- Impaired renal function
不良反應
- Myelosuppression (leucopenia, thrombocytopenia)
- Anorexia
- Nausea
- Vomiting
- Pulmonary infiltrates
- Pulmonary fibrosis
- Oral ulceration (reported in humans)
藥物相互作用
- Cimetidine · Decreases the oral bioavailability of melphalan · moderate
- Steroids · Enhance the antitumour effects of melphalan · moderate
- Ciclosporin · Enhances the risk of renal toxicity (reported in humans) · major
監測
- Complete Blood Count (CBC) - monitor for leucopenia and thrombocytopenia
- Renal function panel
- Gastrointestinal signs (anorexia, vomiting)
- Respiratory rate and effort (for pulmonary infiltrates/fibrosis)
過量
Overdosage primarily manifests as severe **myelosuppression** (profound neutropenia and thrombocytopenia) and severe **gastrointestinal toxicity** (vomiting, diarrhea, ulceration). Treatment is supportive, including broad-spectrum antibiotics for neutropenia, antiemetics, and potentially blood transfusions or colony-stimulating factors.
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。