阿曲庫銨
阿曲庫銨是一種中效非去極化神經肌肉阻斷劑，用於獸醫麻醉。它提供**神經肌肉阻斷**，透過肌肉鬆弛改善手術視野，促進正壓換氣，並特別適用於眼內手術（例如使眼球居中）。 其作用時間為中等（15-35分鐘），且因其獨特的非酵素降解途徑（**霍夫曼消除**）而不會在體內蓄積。由於其清除不依賴肝臟和腎臟功能，因此非常適合用於患有肝腎疾病的動物。 > **臨床提示：** 阿曲庫銨不具備任何鎮痛或鎮靜作用，必須嚴格在患者完全麻醉的情況下使用。
作用機制: Atracurium acts as a competitive antagonist at the neuromuscular junction. It inhibits the actions of **acetylcholine** → binds competitively to the **nicotinic acetylcholine receptors** on the post-junctional membrane of skeletal muscle → prevents acetylcholine from binding → prevents muscle cell depolarization → results in flaccid muscle paralysis.
各物種劑量
- Neuromuscular blockade during anaesthesia · 0.2-0.5 mg/kg initially, followed by increments of 0.2 mg/kg · IV · as needed · Intermediate duration (15-35 min) · Monitor with nerve stimulator
- Neuromuscular blockade during anaesthesia · 0.2-0.5 mg/kg initially, followed by increments of 0.2 mg/kg · IV · as needed · Intermediate duration (15-35 min) · Monitor with nerve stimulator
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
禁忌症
- Conscious or inadequately anesthetized animals
- Lack of positive pressure ventilation facilities
- Lack of trained personnel to monitor neuromuscular blockade
- Conscious animals (must NEVER be administered unless the animal is adequately anesthetized)
不良反應
- Histamine release (especially with rapid IV injection)
- Bronchospasm
- Hypotension
- Tachycardia
- Histamine release (especially with rapid IV administration)
藥物相互作用
- Volatile anaesthetics · Prolonged neuromuscular blockade · major
- Aminoglycosides · Prolonged neuromuscular blockade · moderate
- Clindamycin · Prolonged neuromuscular blockade · moderate
- Lincomycin · Prolonged neuromuscular blockade · moderate
監測
- Neuromuscular function (using a peripheral nerve stimulator / Train-of-Four)
- Respiratory rate and effort (mechanical ventilation parameters)
- End-tidal CO2 (capnography)
- Oxygen saturation (pulse oximetry)
- Heart rate and rhythm (ECG)
- Blood pressure
- Core body temperature
- Neuromuscular function (using a peripheral nerve stimulator/Train-of-Four monitor)
- Respiratory rate, effort, and end-tidal CO2
- Heart rate and blood pressure
- Core body temperature (hypothermia prolongs effect)
- Acid-base status and potassium levels
過量
Overdosage results in **prolonged neuromuscular blockade** and respiratory paralysis. * **Management:** Requires continuous mechanical positive pressure ventilation until spontaneous recovery occurs. * **Reversal:** Pharmacological reversal agents (e.g., neostigmine or edrophonium) combined with an anticholinergic (e.g., atropine or glycopyrrolate to prevent severe bradycardia) should be administered once signs of spontaneous recovery begin (confirmed via nerve stimulator).
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。