阿朴嗎啡
Apomorphine
Apomorphine hydrochloride
別名: Apokyn · APO-go · Apofin · Apokinon · Apomine · Britaject · Ixense · Taluvian · Uprima · Apometic · apomorphini hydrochloridum
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
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Induction of emesis | 0.03 mg/kg IV or 0.04 mg/kg IM (IV route preferred); alternatively a portion of tablet may be crushed in a syringe, dissolved with few drops of water and administered into the conjunctival sac. After sufficient vomiting occurs, rinse conjunctival sac free of unabsorbed apomorphine. | IV/IM/Topical | Once | — | 🌎 NA |
| Induction of emesis | 0.04 mg/kg IV or 0.08 mg/kg IM or SC | IV/IM/SC | Once | — | 🌎 NA |
| Induction of emesis | 0.04 mg/kg IV, 0.07 mg/kg IM, or 0.25 mg/kg into the conjunctival sac | IV/IM/Topical | Once | — | 🌎 NA |
| Induction of emesis | 0.2 mg/kg | SC | single dose | single dose | 🌍 EU |
| Induction of emesis | 20-40 μg/kg | IV | single dose | single dose | 🌍 EU |
- Induction of emesis: IV route preferred.
- Induction of emesis: Authorized dose. Do not repeat if ineffective.
- Induction of emesis: Non-authorized dose and route but some evidence suggests it is at least as effective.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Induction of emesis | 0.04 mg/kg IV or 0.08 mg/kg IM or SC | IV/IM/SC | Once | — | 🌎 NA |
| Induction of emesis | Not recommended | IM | single dose | single dose | 🌍 EU |
- Induction of emesis: Use of apomorphine in cats is controversial and many recommend not using in this species.
- Induction of emesis: Xylazine is a potent emetic in cats and at least as safe.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
阿朴嗎啡是一種合成的鴉片類衍生物，但與嗎啡不同，它缺乏顯著的鎮痛作用。在獸醫學中，它被廣泛認為是犬隻的首選催吐劑，用於迅速排除誤食的毒物。
- 作用迅速： 經由腸胃外（靜脈/肌肉注射）或點入結膜囊給藥時，能非常快速地引發嘔吐。
- 物種特異性： 對犬隻極為有效。由於在貓的療效較差且有潛在的安全疑慮，其在貓的使用具爭議性，通常不建議使用。
- 限制： 與所有催吐劑一樣，它通常只能清除胃內 40-60%（最多 80%）的內容物。成功催吐並不代表不需要進一步的毒物學監測或治療（例如給予活性碳）。
作用機轉
Apomorphine acts as a non-selective dopamine agonist.
It directly stimulates D2-dopaminergic receptors in the chemoreceptor trigger zone (CRTZ) located in the area postrema of the medulla oblongata.
Mechanism Pathway: Apomorphine administration → Crosses the blood-brain barrier → Stimulates D2 receptors in the CRTZ → Activates the central vomiting center → Initiates the emetic reflex.
Clinical Pearl: The CRTZ in dogs is highly sensitive to dopamine, making apomorphine highly effective. In contrast, the feline CRTZ is mediated primarily by alpha-2 adrenergic receptors, which is why alpha-2 agonists (like xylazine or dexmedetomidine) are the preferred emetics for cats, while apomorphine is often ineffective.
安全性與警告
禁忌症
- Rodents and rabbits (unable to vomit or lack stomach wall strength)
- Hypoxia, dyspnea, or shock
- Lack of normal pharyngeal reflexes (risk of aspiration)
- Seizuring, comatose, or severely CNS-depressed patients
- Patients who have already vomited repeatedly
- Ingestion of strong acids, alkalis, or other caustic agents (risk of esophageal/gastric rupture)
- Ingestion of petroleum distillates (unless toxicity risk outweighs aspiration risk)
- Ingestion of strychnine or other CNS stimulants (may precipitate seizures)
- Oral opiate or other CNS depressant (e.g., barbiturates) toxicity
- Hypersensitivity to morphine
不良反應
- Protracted vomiting
- CNS depression (lethargy, sedation)
- CNS stimulation (excitement, restlessness)
- Respiratory depression
- Corneal ulcers (anecdotal, associated with conjunctival administration)
注意事項
If vomiting does not occur within the expected time after apomorphine administration, repeated doses are unlikely to induce emesis and may cause clinical signs of toxicity. Use with extreme caution, if at all, in cats. When using the conjunctival route, the eye must be thoroughly rinsed with sterile saline after emesis is achieved to prevent protracted vomiting and potential corneal irritation.
藥物交互作用
May negate the emetic effects of apomorphine by blocking dopamine receptors in the CRTZ.
May cause severe hypotension; concurrent use is contraindicated in humans.
Additive CNS or respiratory depression may occur.
May reduce the emetic effects of apomorphine
Additive CNS or respiratory depression
監測
- CNS status (depression or excitement)
- Respiratory rate and effort
- Heart rate and rhythm
- Vomitus (quantify volume, examine for toxic contents, and save for possible later analysis)
藥物動力學
吸收
Slowly absorbed after oral administration with unpredictable efficacy. Rapidly absorbed after IM administration (vomiting generally within 5 minutes). Topical administration to the conjunctival sac is usually effective but less so than IV or IM.
分佈
Readily crosses the blood-brain barrier to access the chemoreceptor trigger zone.
代謝
Primarily conjugated in the liver.
排除
Excreted in the urine.
過量
Excessive doses of apomorphine may result in:
- Respiratory and/or cardiac depression
- CNS stimulation (excitement, seizures) or severe CNS depression
- Protracted vomiting
Treatment:
- Naloxone may reverse the CNS and respiratory depressant effects of the drug, but it cannot be expected to halt the vomiting.
- Atropine has been suggested to treat severe bradycardias associated with overdose.
- If protracted vomiting occurs from conjunctival administration, thoroughly flush the eye with sterile saline.
可用產品
劑型
- Injection
- Soluble tablets (often used for conjunctival administration or compounding)
獸醫用
- Pharmaceutical dosage forms of apomorphine have been occasionally difficult to obtain; compounding pharmacies may be required to obtain the drug.
人用標示
- Apomorphine HCl Injection: 10 mg/mL in 2 mL amps and 3 mL cartridges (Apokyn)
各地核准狀態
POM-V
POM-V
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store soluble tablets in tight containers at room temperature (15-30°C) and protect from light. Upon exposure to light and air, apomorphine gradually darkens in color. Do not use discolored tablets or solutions (green to turquoise). Solutions are more stable in acidic than in alkaline environments. Compounded sterile solutions (with sodium metabisulfite) can retain potency for two months at 25°C if protected from light. Do not autoclave solutions, as this causes a green discoloration.
飼主須知
阿朴嗎啡是一種速效藥物，專門在專業獸醫的監督下使用，用於寵物誤食潛在危險物質後引發嘔吐。
- 預期情況： 您的狗狗在接受藥物後幾分鐘內通常就會嘔吐。
- 後續護理： 胃部排空後，您的寵物可能會經歷短暫的噁心、嗜睡或精神不振。
- 重要提示： 催吐只是治療中毒的第一步。根據寵物誤食的物質，您的獸醫可能會建議進一步的治療，例如給予活性碳或靜脈輸液。
VetSheet 藥物參考供合格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商最新仿單。