卡洛芬
**卡洛芬 (Carprofen)** 是一種丙酸類非類固醇消炎止痛藥 (NSAID)，在獸醫學中被廣泛使用。 * **主要用途：** 用於犬隻骨關節炎相關的疼痛與發炎管理，以及軟組織與骨科手術後的術後疼痛控制。 * **臨床要點：** 雖然療效顯著，但需要謹慎選擇病患，以避免胃腸道、腎臟或肝臟的不良反應。 > **注意：** 卡洛芬通常被認為是 COX-2 偏向性 NSAID，這意味著它針對發炎途徑，同時在很大程度上保留了 COX-1 的保護性恆定功能。
作用機制: Carprofen produces its analgesic and anti-inflammatory effects via the inhibition of cyclooxygenase (COX) enzymes. **Arachidonic Acid** → **Cyclooxygenase (COX)** → **Prostaglandins & Thromboxanes** * **COX-1 Sparing:** It preferentially inhibits **COX-2** (induced during inflammation) over **COX-1** (constitutively expressed for GI and renal protection). * **Additional Mechanisms:** May also inhibit the release of several prostaglandins and modulate cellular and humoral immune responses.
各物種劑量
- Post-operative pain · 4 mg/kg · SC/IV · Single dose · One time only · Use with extreme caution in cats due to limited glucuronidation capacity; single dose only. Not approved for multi-day use in cats in many countries.
- Analgesia · 1-2 mg/kg · PO/SC · q12-24h · As needed
- Adjunct therapy for acute mastitis or respiratory disease · 1.4 mg/kg · SC/IV · Single dose · One time · Approved in some regions outside the US.
- Pain and Inflammation · 0.7 mg/kg · IV · q24h · As needed · Used primarily outside the US.
- Analgesia · 1-2 mg/kg · PO/IM/SC · q12-24h · As needed · Dosing varies significantly by species.
- Analgesia · 2-5 mg/kg · PO/SC · q12-24h · As needed · Commonly used in rabbits, guinea pigs, and rodents.
- Osteoarthritis and Pain Management · 4.4 mg/kg · PO/SC/IV · q24h or divided q12h · As needed · Can be given as a single daily dose or divided into 2.2 mg/kg twice daily.
- Analgesia · 2-4 mg/kg · PO/IM/SC · q24-72h · As needed · Metabolism is highly temperature-dependent.
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
- Bleeding disorders (e.g., Von Willebrand disease)
- Active gastrointestinal ulceration
- Hypersensitivity to carprofen or other NSAIDs
- Concurrent use with other NSAIDs or corticosteroids
不良反應
- Vomiting
- Diarrhea
- Anorexia
- Lethargy
- Gastrointestinal ulceration or bleeding
- Hepatopathy (rare, idiosyncratic)
- Renal toxicity
藥物相互作用
- Corticosteroids · Significantly increased risk of gastrointestinal ulceration and perforation. · major
- Other NSAIDs · Increased risk of GI, renal, and hepatic toxicity. · major
- ACE Inhibitors · Potential for increased risk of renal toxicity and decreased hypotensive efficacy. · moderate
- Phenobarbital · Potential for altered metabolism and increased risk of hepatotoxicity.
- Furosemide · Decreased diuretic efficacy. · moderate
監測
- Baseline blood work (CBC/Chemistry panel)
- Liver enzymes (ALT, AST, ALP, Bilirubin)
- Renal parameters (BUN, Creatinine, SDMA, USG)
- Clinical signs of GI upset (vomiting, diarrhea, melena)
過量
**Signs of Toxicity:** * **GI:** Vomiting, diarrhea, hematemesis, melena, GI ulceration/perforation. * **Renal:** Acute kidney injury (AKI), polyuria, polydipsia. * **Hepatic:** Elevated liver enzymes, icterus. * **Neurologic:** Seizures or coma in massive overdoses. **Treatment:** 1. **Decontamination:** Emesis induction (if recent and asymptomatic), followed by activated charcoal. 2. **GI Protectants:** Omeprazole, misoprostol, sucralfate. 3. **Fluid Therapy:** IV crystalloids to support renal perfusion and promote diuresis. 4. **Monitoring:** Serial monitoring of renal and hepatic values for at least 48-72 hours.
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