帕米膦酸
**帕米膦酸**是一種雙磷酸鹽類藥物，在獸醫學中主要用於治療**高血鈣症**，特別是與維生素D中毒（如誤食含膽鈣化醇的殺鼠劑）或惡性腫瘤引起的高血鈣症相關。 > **臨床警告：** 帕米膦酸可能引起腎臟毒性，對於已有腎功能障礙的病患為禁忌症。給藥期間必須保持充足的水分。 **臨床提示：** 除了治療高血鈣症外，帕米膦酸也常被用作輔助鎮痛劑，以緩解犬隻惡性骨溶解和骨腫瘤（如骨肉瘤）相關的疼痛。
作用機制: Pamidronate binds strongly to hydroxyapatite crystals in the bone matrix. It **inhibits osteoclast activity** and **induces osteoclast apoptosis** → decreases bone resorption → lowers serum calcium concentrations and reduces osteolytic bone destruction and associated pain.
各物種劑量
- Hypercalcaemia / Bone tumour pain · 0.65-2 mg/kg (typically 1 mg/kg) slow infusion with NaCl 0.9% over 2-4 hours · IV · q28days if required · As needed · Some clinicians advocate 0.9% NaCl i.v. for 2 hours before and after the infusion.
- Cholecalciferol-induced toxicosis · 0.65-2 mg/kg (typically 1 mg/kg) slow infusion with NaCl 0.9% over 2-4 hours · IV · On days 1 and 4 post-ingestion · 2 doses · Some clinicians advocate 0.9% NaCl i.v. for 2 hours before and after the infusion.
- Hypercalcaemia · 1.0-2.0 mg/kg slow (over 4 hours) infusion · IV · Single dose · Over 4 hours
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
- Renal dysfunction
不良反應
- Renal toxicity
- Nausea
- Diarrhoea
- Hypocalcaemia
- Hypophosphataemia
- Hypomagnesaemia
- Hypersensitivity reactions
- Ophthalmic syndromes (reported in humans)
- Bone pain (reported in humans)
- Electrolyte abnormalities (reported in humans)
- Blood dyscrasias (reported in humans)
藥物相互作用
- Aminoglycosides · Concurrent use may result in severe hypocalcaemia · major
- NSAIDs · Increased risk of renal toxicity; use with caution · moderate
監測
- Serum calcium (ionized and total)
- Serum phosphorus
- Serum magnesium
- Renal function panel (BUN, Creatinine, USG)
- Hydration status
過量
Overdosage may lead to severe **hypocalcaemia**, **hypophosphataemia**, and **hypomagnesaemia**, as well as acute renal failure. Treatment is supportive, including intravenous fluids and electrolyte supplementation (e.g., calcium gluconate) as dictated by serum monitoring.
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。