胰脂酶 / 胰臟酵素
胰脂酶是主要從豬胰臟提取的消化酵素（脂肪酶、蛋白酶和澱粉酶）的組合。它是治療**胰臟外分泌不足 (EPI)** 的核心藥物。EPI 是一種胰臟無法合成和分泌足夠消化酵素的疾病，會導致嚴重的消化不良、多食但體重減輕以及大量脂肪便。 **臨床要點：** * 由於胰腺腺泡萎縮，EPI 在德國牧羊犬和粗毛牧羊犬等特定品種中尤為常見。 * 診斷通常透過物種特異性的**胰蛋白酶樣免疫反應 (TLI)** 檢測來確認。 * 雖然療效顯著，但約有 15% 的犬隻可能對單純的酵素補充反應不佳，可能需要同時處理腸道菌群失調（抗生素反應性腸病）、調整飲食（如高消化率、低纖維飲食）或補充維生素 B12 (Cobalamin)。
作用機制: Pancrelipase acts locally in the duodenum and jejunum to replace missing endogenous pancreatic enzymes, facilitating the breakdown of macronutrients into absorbable molecules: * **Lipase** hydrolyzes triglycerides → free fatty acids and monoglycerides. * **Protease** (including trypsin and chymotrypsin) cleaves peptide bonds in proteins → oligopeptides and free amino acids. * **Amylase** hydrolyzes complex carbohydrates (starches) → dextrins and simple sugars (maltose). These enzymes resolve maldigestion and secondary malabsorption, allowing the animal to properly absorb nutrients and gain weight.
各物種劑量
- Pancreatic exocrine insufficiency · 0.5-0.75 teaspoonsful with each meal mixed with food · PO · with each meal · Mix with food thoroughly and allow it to stand for 15-20 minutes before feeding. Best results are usually obtained by feeding small meals frequently (at least 3 times per day).
- Pancreatic exocrine insufficiency · 1 teaspoonful of powder or finely crushed nonenteric-coated tablets to each of two meals of balanced feline ration · PO · with each meal (twice daily) · Cats that refuse to eat food treated with powder may be dosed with capsules filled with powder or crushed non-enteric coated tablets. Not necessary to incubate before feeding.
- Pancreatic exocrine insufficiency · 0.5 teaspoonsful of powder per meal · PO · with each meal
- Pancreatic exocrine insufficiency · Initially, one teaspoon per cat per meal · PO · with each meal · When clinical signs have resolved, gradually decrease to the lowest effective dose.
- Pancreatic exocrine insufficiency · 1/8 tsp per kg · PO · with meals · Mix with moistened feed or administer by gavage. Incubate with food for 15 minutes prior to gavage.
- Gastric trichobezoars (Rabbits) · 1 teaspoonful (5 mL) pancrelipase powder plus 3 teaspoonsful (15 mL) of yogurt; let stand for 15 minutes, then give 2-3 mL · PO · q12h · Questionable efficacy for removing 'hairballs', but might help dissolve the protein matrix surrounding hair.
給藥途徑
禁忌症
- Hypersensitivity to pork proteins
不良反應
- GI distress (diarrhea, cramping, nausea) at high doses
- Oral or esophageal ulcers (from concentrated enzymes)
- Oral bleeding (reported in dogs)
藥物相互作用
- Antacids (magnesium hydroxide, calcium carbonate) · May diminish the effectiveness of pancrelipase
- Cimetidine (or other H2 antagonists) · May increase the amount of pancrelipase that reaches the duodenum
監測
- Animal's weight
- Stool consistency and frequency
過量
Overdosage may cause diarrhea or other intestinal upset (cramping, nausea). The effects should be temporary; treat by reducing the dosage and providing supportive care if diarrhea is severe.
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。