丁基東莨菪鹼
丁基東莨菪鹼（又稱 hyoscine butylbromide）是一種強效的注射型**抗膽鹼**與**抗痙攣**藥物，主要用於馬匹醫學。 * **主要臨床用途**：快速緩解馬匹因痙攣性疝痛、氣體性疝痛及單純性腸阻塞引起的腹痛。也可用於輔助直腸檢查與結腸鏡檢查。 * **臨床要點**：由於其為**四級銨化合物**，極性高且不易穿過血腦屏障。這意味著它能對胃腸道與泌尿道產生優異的周邊抗痙攣效果，而不會產生如阿托品 (atropine) 常見的嚴重中樞神經系統副作用（如興奮或嚴重鎮靜）。 * 其作用時間比阿托品短得多，非常適合需要短暫介入且不希望造成長時間腸道無力的情況。
作用機制: N-butylscopolammonium bromide acts as a **competitive antagonist** at **muscarinic acetylcholine receptors** located on smooth muscle cells. * **Mechanism**: Blocks acetylcholine binding → prevents intracellular calcium release → induces profound relaxation of gastrointestinal and urinary smooth muscle. * **Pathway**: Parasympathetic inhibition → decreased GI peristalsis and reduced rectal pressure. * **Duration**: Visceral antinociceptive and spasmolytic effects are brief, typically lasting 15-20 minutes in horses.
各物種劑量
- Control of abdominal pain (colic) associated with spasmodic colic, flatulent colic, and simple impactions · 0.3 mg/kg (30 mg or 1.5 mL per 100 kg of body weight) · slow IV · one time
- To treat esophageal obstruction · 0.3 mg/kg · IV · once · Administer with oxytocin (0.11-0.22 Units/kg IV once). Oxytocin use should be avoided in mares, or dose significantly reduced. Do not use in pregnant mares.
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
- Impaction colics associated with ileus
- Glaucoma
- Horses intended for food purposes
- Nursing foals
- Pregnant or lactating mares
不良反應
- Transient tachycardia
- Decreased borborygmal sounds
- Transient pupil dilation
- Decreased secretions
- Dry mucous membranes
藥物相互作用
- ATROPINE or other anticholinergic agents · May cause additive effects if used with N-butylscopolammonium
- METOCLOPRAMIDE and other drugs that have cholinergic-like actions on the GI tract · These drugs and N-butylscopolammonium may counteract one another's actions on GI smooth muscle
監測
- Heart rate (Note: heart rate cannot be used as indicator for pain for the first 30 minutes after administration)
- GI motility via gut sounds and feces output
過量
Dosages up to 10X (3 mg/kg) were administered to horses as part of preapproval studies. Clinical effects noted included dilated pupils (returned to normal in 4-24 hours), tachycardia (returned to normal within 4 hours) and dry mucous membranes (returned to normal in 1-2 hours). Gut motility was inhibited, but returned to baseline within 4 hours and normal feces were seen within 6 hours. Two of the four horses treated at 10X dosage developed mild signs of colic which resolved without further 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。