普賴蘇濃 / 潑尼松龍
Prednisolone
Prednisolone acetate, Prednisolone sodium phosphate
別名: Pred Forte · Pred Mild · Econopred Plus · Mydrapred · PLT · Prednicare · Prednidale · Prednisolone acetate · Prednisolone sodium phosphate · Prednisolonum
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
經審核的 v13 劑量證據
結構化劑量計算證據Medical management of insulinoma after stabilization of hypoglycemic crisis
- divided q12h
必須同時考慮的臨床上下文 (3)
- Once hypoglycemic crisis stabilized
- may need to increase dose over time
- Ideal to use H2 blocker concurrently
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。
概覽
普賴蘇濃 (Prednisolone) 是一種強效的中效合成皮質類固醇，在獸醫學中被廣泛使用。在眼科中，它被認為是治療前葡萄膜炎 (anterior uveitis) 的黃金標準和最有效的藥物。
其不同配方在臨床上有重要區別：
- 醋酸普賴蘇濃 (Prednisolone Acetate)：配製為懸浮液。它具有卓越的抗發炎活性，並且能透過完整的角膜極佳地穿透進入眼前段，效果優於地塞米松 (dexamethasone) 產品。
- 磷酸鈉普賴蘇濃 (Prednisolone Sodium Phosphate)：配製為溶液。它穿透完整角膜的效果不如醋酸鹽形式，但適用於眼表面的發炎。
臨床要點：雖然是局部點眼，但普賴蘇濃可經由鼻淚管和結膜血管被全身吸收。在小型動物（20公斤以下）中，頻繁使用可能導致全身性副作用，包括使糖尿病病情不穩定。
作用機制
Prednisolone exerts its effects by diffusing across cell membranes and binding to specific cytosolic glucocorticoid receptors.
The receptor-ligand complex translocates to the nucleus → binds to glucocorticoid response elements (GREs) on DNA → alters gene transcription.
Mechanistically, it induces the synthesis of lipocortin-1 (annexin-1), which inhibits the enzyme phospholipase A2. This inhibition prevents the release of arachidonic acid from membrane phospholipids, thereby potently shutting down the downstream synthesis of inflammatory mediators, including prostaglandins and leukotrienes.
安全性與警告
禁忌症
- Corneal ulcers (absolute contraindication for topical use)
- Ocular viral infections (e.g., Feline Herpesvirus-1)
- Ocular fungal infections
- Use with extreme caution in patients with uncontrolled diabetes mellitus or systemic infectious diseases
- Pregnant animals
- Renal disease (systemic use)
- Diabetes mellitus (systemic use)
- Ulcerative keratitis (topical ophthalmic use)
- Systemic fungal infections
- Concurrent NSAID administration
不良反應
- Systemic absorption leading to iatrogenic hyperadrenocorticism (PU/PD/PP, panting, alopecia)
- Insulin resistance and destabilization of diabetes mellitus
- Delayed corneal healing
- Potentiation or exacerbation of ocular infections (bacterial, viral, fungal)
- Corneal degeneration or calcification (with long-term topical use)
- Hypothalamic-pituitary axis (HPA) suppression
- Adrenal atrophy
- Proteinuria and glomerular changes (dogs)
- Weight loss and muscle atrophy (catabolic effects)
- Iatrogenic hyperadrenocorticism (Cushing's syndrome)
- Vomiting and diarrhoea
- Gastrointestinal ulceration
- Hyperglycaemia
- Decreased serum T4 values
- Impaired wound healing
- Delayed recovery from infections
- Polyuria/polydipsia (PU/PD)
- Polyphagia
- Immunosuppression
- Muscle wasting
注意事項
Important Warning: Subconjunctival and topical steroids can be absorbed systemically. Use with extreme caution in patients with endocrinopathies (e.g., diabetes mellitus) or infectious diseases.
Even frequent topical steroid application in small animal patients under 20 kg can cause difficulties with diabetes mellitus regulation. Once the peak inflammatory response has been suppressed, consider transitioning to nonsteroidal anti-inflammatory drugs (NSAIDs) for ongoing maintenance treatment to minimize systemic steroid exposure.
藥物相互作用
Concurrent use may increase the risk of delayed corneal healing or corneal melting, though sometimes used together cautiously for severe inflammation.
Systemically absorbed prednisolone antagonizes insulin, increasing blood glucose and complicating diabetes regulation.
Increased risk of gastrointestinal ulceration if significant systemic absorption of prednisolone occurs.
Increased risk of gastrointestinal ulceration
Increased risk of hypokalaemia
Increased risk of hypokalaemia
Increased risk of hypokalaemia
Enhanced metabolism of corticosteroids
Enhanced metabolism of corticosteroids
Decreased metabolism of corticosteroids
Synergistic immunosuppression; may alter pharmacokinetics
監測
- Resolution of clinical signs of uveitis (aqueous flare, miosis, pain, photophobia)
- Intraocular pressure (IOP) to monitor for secondary glaucoma
- Fluorescein staining (to ensure no corneal ulceration develops)
- Blood glucose and water intake/urine output in diabetic or small patients
- Clinical response to therapy
- Haematocrit (in cases of IMHA)
- Blood glucose (risk of hyperglycaemia)
- Serum T4 values (may be decreased)
- Renal parameters and urinalysis (proteinuria in dogs)
- Signs of GI ulceration (vomiting, melaena)
- Haematology at each visit (including 4 and 8 weeks after cessation of therapy)
- PCV (Packed Cell Volume)
- Liver parameters (especially if combined with azathioprine)
- Clinical signs of anaemia or GI bleeding
藥物動力學
半衰期
吸收
Prednisolone acetate is highly lipophilic and readily penetrates the intact corneal epithelium to reach therapeutic concentrations in the aqueous humor. Systemic absorption occurs via drainage through the nasolacrimal duct into the nasal mucosa and GI tract.
分佈
Distributes widely into ocular tissues (anterior segment). Systemically absorbed drug distributes throughout total body water and binds to plasma proteins (transcortin and albumin).
代謝
Systemically absorbed prednisolone is metabolized primarily in the liver.
排除
Excreted primarily by the kidneys as conjugated metabolites.
過量
Acute overdose from topical ophthalmic application is highly unlikely to cause severe toxicity. However, chronic overdosage or overly frequent application (especially in small patients <20 kg) can lead to systemic absorption resulting in iatrogenic hyperadrenocorticism (Cushing's syndrome), adrenal suppression, and destabilization of blood glucose in diabetic patients. If a corneal ulcer is present, overuse can lead to rapid corneal melting and perforation.
可用產品
劑型
- Ophthalmic suspension (0.12%, 0.125%, 1%)
- Ophthalmic solution (0.125%, 1%)
- Ophthalmic drops combined with atropine
- Ophthalmic suspension: 0.5%, 1% (5 ml, 10 ml bottles)
- Topical preparations (dermatological, otic, ophthalmic)
- Injectable solution: prednisolone sodium succinate 10 mg/ml
- Injectable suspension: 7.5 mg/ml (plus 2.5 mg/ml dexamethasone)
- Oral tablets: 1 mg, 5 mg, 25 mg
- Oral compound: PLT (contains cinchophen)
- Oral suspension
獸醫用
- PLT (compound with cinchophen)
- Prednicare
- Prednidale
人用標示
- Prednisolone Acetate Drops: 0.12% Suspension (Pred Mild®)
- Prednisolone Acetate Drops: 0.125% Suspension (Econopred®)
- Prednisolone Acetate Drops: 1% Suspension (Econopred Plus®, Pred Forte®, generic)
- Prednisolone Sodium Phosphate Drops: 0.125% & 1% Solution (various)
- Prednisolone (0.25%) and Atropine (1%) Drops (Mydrapred®)
- Pred-forte (ophthalmic suspension 0.5%, 1%)
- Prednisolone tablets
各地核准狀態
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儲存與穩定性
Store at room temperature (15°-25°C / 59°-77°F). Protect from freezing. Keep the bottle tightly closed when not in use. Suspensions must be stored upright.
飼主須知
關鍵步驟：如果您使用的是醋酸鹽懸浮液（例如 Pred Forte），每次使用前必須用力搖勻藥瓶。藥物成分會沉澱在底部，如果不搖勻，您滴入眼睛的將只剩水分。
- 給藥方式：使用前請洗手。請勿讓滴管尖端接觸寵物的眼睛、眼瞼或任何其他表面，以防污染。
- 間隔時間：如果您需要點多種眼藥水，每種藥物之間請至少等待 5 到 10 分鐘。
- 注意潰瘍徵兆：類固醇會延緩癒合。如果寵物的眼睛變得更紅、混濁，或者開始瞇眼、抓撓眼睛，請立即停藥並聯繫您的獸醫師。這可能表示有角膜刮傷或潰瘍。
- 全身性症狀：即使是眼藥水也可能被身體吸收。請觀察寵物是否有喝水量增加、排尿量增加或食慾增加的情況，並向獸醫師報告。
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