普瑞巴林
普瑞巴林 (Pregabalin) 是一種 GABA 的結構類似物，與加巴噴丁 (Gabapentin) 相似，在獸醫學中主要用作**抗癲癇藥**和**神經病理性疼痛鎮痛藥**。 * **主要用途**：作為難治性或複雜部分性癲癇發作的輔助治療，以及慢性/神經病理性疼痛的管理。 * **臨床要點**：其效力被認為是加巴噴丁的 3-10 倍，因此可以使用較低的劑量體積，這對小型病患非常有利。 * **安全性**：通常耐受性良好，最常見的劑量依賴性副作用為鎮靜和共濟失調。目前關於其在犬貓中的安全性和有效性資訊有限但正在增加。
作用機制: Pregabalin is a structural analog of the inhibitory neurotransmitter **gamma-aminobutyric acid (GABA)**. Despite its structure, it does not bind directly to GABA receptors. * Binds with high affinity to the **alpha-2-delta (α2δ) subunit** of **voltage-gated calcium channels (CaV)** in the central nervous system. * Binding → Decreased calcium influx at nerve terminals → Inhibition of the release of excitatory neurotransmitters (e.g., **glutamate**, **substance P**, **norepinephrine**). * This reduction in excitatory neurotransmission produces its **analgesic**, **anticonvulsant**, and **anxiolytic** effects.
各物種劑量
- Seizure disorders (anecdotal) · 1-2 mg/kg PO q12h · PO · q12h · Most commonly mentioned anecdotal dose.
- Seizure disorders (PK theory) · 1-2 mg/kg PO twice daily · PO · q12h · Theorized reasonable starting dose based on single-dose PK study.
- Neuropathic pain and seizures (extrapolated from PK study) · 4 mg/kg PO twice daily · PO · q12h · Would produce plasma levels within the extrapolated therapeutic range.
- Seizure disorders · 3-4 mg/kg PO every 8 hours · PO · q8h · To minimize side effects, initially start on 2 mg/kg and increase by 1 mg/kg each week until target dose is reached.
- Seizure disorders · gradually increased from 2 mg/kg PO to 3-4 mg/kg q8-12h · PO · q8-12h · Gradual increase needed to minimize sedation.
- Refractory seizures (adjunct therapy) · 2 mg/kg q8-12h, increasing 1 mg/kg/dose each week to a total of 3-4 mg/kg · PO · q8-12h · Used as a third anticonvulsant if control cannot be obtained with phenobarbital and bromides.
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
- Hypersensitivity to pregabalin
- Pregnant animals (toxicity demonstrated in experimental studies)
- Abrupt discontinuation
不良反應
- Sedation
- Ataxia
- Somnolence
- Dizziness
- Difficulty with concentration/attention/memory
- Blurred vision
- Dry mouth
- Peripheral edema
- Constipation
- Weight gain
- Syncope
- Congestive heart failure
- Renal failure (reversible)
- Rhabdomyolysis
- Hypersensitivity reactions (angioedema, rash, blisters, wheezing)
- Decreased platelet production
- Increased creatine kinase
藥物相互作用
- ACE Inhibitors (e.g., benazepril, enalapril) · In humans, coadministration may increase risks of edema and hives.
- CNS Depressants · May cause additive CNS depression.
- NSAIDs (e.g., ketorolac, naproxen) · In humans, cited as possibly reducing anticonvulsant effectiveness, though substantive evidence is weak.
監測
- Efficacy (seizure frequency, pain scores)
- Adverse effects (sedation, ataxia)
- Seizure frequency and severity
- Pain scores
- Renal function (BUN, creatinine, USG)
- Hepatic enzyme activities (during prolonged therapy)
過量
There is limited experience with overdoses of pregabalin in veterinary medicine. One human ingested 8 grams without significant effect. There is no specific antidote for overdose. Standard decontamination protocols can be employed if indicated. Contact an animal poison center for more information.
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。