金硫葡萄糖
Aurothioglucose
Gold thioglucose
別名: Solganal · Gold thioglucose · Gold salts · Chrysotherapy
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
各物種劑量
此藥的劑量資料尚未收錄於 VetSheet 藥典，以下其他章節資料完整。開立處方前請參閱最新仿單。
概覽
金硫葡萄糖是一種注射用金鹽，歷史上在獸醫學中用於其免疫調節和抗發炎特性。
- 這種被稱為金鹽療法 (chrysotherapy) 的治療方法，主要用於治療嚴重的免疫介導性皮膚病（如落葉型天皰瘡）和免疫介導性多發性關節炎。
- 臨床要點： 由於更安全、起效更快且更有效的免疫抑制劑（如環孢素、麥考酚酯、糖皮質激素）的出現，金硫葡萄糖在現代獸醫臨床中已很少使用。
- 它需要較長的起效時間（通常為數週至數月），並且具有嚴重的、可能危及生命的不良反應風險，包括嚴重的骨髓抑制和腎毒性。
作用機轉
The exact mechanism of chrysotherapy remains incompletely understood, but it is known to exert profound immunomodulatory effects.
- Macrophage Inhibition: Gold compounds are taken up by macrophages → inhibition of phagocytosis → decreased release of lysosomal enzymes and inflammatory mediators.
- T-Cell Modulation: Alters cellular immunity by reducing the proliferation and activation of T-lymphocytes.
- Autoantibody Reduction: Decreases the production of rheumatoid factor and other autoantibodies.
- Inhibits prostaglandin synthesis and complement activation, contributing to its anti-inflammatory effects.
安全性與警告
禁忌症
- Pre-existing renal disease
- Hepatic dysfunction
- Severe hematologic disorders or pre-existing cytopenias
- Systemic lupus erythematosus (SLE)
- Pregnancy and lactation
- History of severe toxicity to heavy metals
不良反應
- Bone marrow suppression (thrombocytopenia, anemia, leukopenia)
- Nephrotoxicity (proteinuria, glomerulonephritis)
- Hepatotoxicity
- Stomatitis and oral ulcers
- Dermatologic reactions (Toxic epidermal necrolysis, Erythema multiforme)
- Anaphylaxis (rare)
注意事項
Strict Monitoring Required: Requires strict monitoring of complete blood counts (CBC) and urinalysis prior to every injection due to the high risk of cumulative toxicity. Discontinue immediately if proteinuria, significant drop in platelet count, or leukopenia develops. Must be administered via deep intramuscular injection.
藥物交互作用
Increased risk of severe hematologic and renal toxicity.
Synergistic bone marrow suppression; use together with extreme caution.
Increased risk of blood dyscrasias.
監測
- Complete Blood Count (CBC) with platelets (prior to every dose)
- Urinalysis (specifically monitoring for proteinuria prior to every dose)
- Liver enzyme panels
- Renal function panels (BUN, Creatinine)
- Clinical signs of bleeding, bruising, or oral ulcers
藥物動力學
半衰期
吸收
Slowly and erratically absorbed from intramuscular injection sites due to its formulation as a suspension in sesame oil.
分佈
Highly protein-bound (primarily to albumin). Accumulates heavily in the reticuloendothelial system, kidneys, liver, bone marrow, and spleen.
代謝
Gold salts are not significantly metabolized.
排除
Excreted primarily via the kidneys (urine) and to a lesser extent in feces. Excretion is very slow, and gold can remain in the body for months to years after discontinuation.
過量
Overdosage can lead to severe heavy metal toxicity.
- Symptoms: Profound bone marrow suppression (bleeding, severe infections), acute renal failure, and severe gastrointestinal signs.
- Treatment: Involves immediate discontinuation of the drug, aggressive supportive care, and potential use of heavy metal chelating agents such as dimercaprol (BAL) to enhance excretion.
可用產品
劑型
- Injectable suspension (in sesame oil)
人用標示
- Solganal (50 mg/mL suspension in sesame oil) - Historically available, now largely discontinued
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store at room temperature (15-30°C); protect from light. Do not freeze. Shake well before use to ensure uniform suspension.
飼主須知
重要提示： 由於有更安全的替代藥物，目前已很少使用金鹽療法。如果開立此藥，需要極度配合監測和獸醫回診。
- 延遲效應： 此藥物需要數週至數月才能顯現療效。請勿僅因未見立即改善而停藥。
- 頻繁檢測： 您的寵物需要頻繁進行血液和尿液檢查（初期通常為每週一次），以確保藥物不會損害其腎臟或骨髓。
- 警訊： 請密切觀察是否有瘀傷、出血（如流鼻血、血便）、嗜睡、牙齦蒼白或口腔潰瘍的跡象。若發生上述任何情況，請立即聯繫您的獸醫師。
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