地塞米松
Dexamethasone
9-fluoro-11β,17,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione
別名: Decadron · Dexasone · Azium · Maxidex · Dexamethasone sodium phosphate · Dexamethasone base · Dexamethasone alcohol
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
經審核的 v13 劑量證據
結構化劑量計算證據Emergency glucocorticoid use in a ferret collapsed from suspected insulinoma
須由已驗證獸醫確認
必須一併考量的臨床脈絡 (1)
- Has not been found to result in improved neurologic recovery or have other positive effects on post-arrest outcome. Thus, its use is not recommended, except in ferrets with collapse due to (suspected) insulinoma. May also be used to treat anaphylactic shock
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
地塞米松 (Dexamethasone) 是一種高效、長效的合成糖皮質激素，在獸醫學中廣泛用於其強大的抗發炎和免疫抑制特性。
- 效力： 其效力大約是氫化可的松 (皮質醇) 的 25-30 倍，且幾乎沒有鹽皮質激素 (保水) 活性。
- 劑型： 可作為醇基或磷酸鹽衍生物 (懸浮液、溶液或軟膏) 使用。醇基形式的抗發炎功效通常優於磷酸鹽衍生物。
臨床重點： 由於其較長的生物半衰期 (>36-72 小時) 且缺乏鹽皮質激素活性，地塞米松非常適合用於高劑量免疫抑制治療、急性過敏反應或診斷測試。但由於有嚴重抑制下丘腦-垂體-腎上腺 (HPA) 軸的風險，不適合用於隔日維持治療。
作用機轉
Dexamethasone exerts its effects by diffusing across cell membranes and binding to specific cytosolic glucocorticoid receptors (GR).
- Transactivation: The receptor-ligand complex translocates to the nucleus → binds to glucocorticoid response elements (GREs) on DNA → upregulates the expression of anti-inflammatory proteins like lipocortin-1 (annexin A1). Lipocortin-1 inhibits phospholipase A2, thereby blocking the release of arachidonic acid and the subsequent synthesis of inflammatory prostaglandins and leukotrienes.
- Transrepression: It inhibits transcription factors such as NF-κB and AP-1 → downregulates the production of pro-inflammatory cytokines (e.g., IL-1, IL-6, TNF-α).
安全性與警告
禁忌症
- Systemic fungal infections
- Active viral infections
- Corneal ulcers (especially for ophthalmic preparations)
- Concurrent use of NSAIDs
- Known hypersensitivity to the drug
不良反應
- Polyuria (PU) and Polydipsia (PD)
- Polyphagia (increased appetite)
- Panting (especially in dogs)
- Gastrointestinal ulceration or bleeding
- Iatrogenic hyperadrenocorticism (Cushing's syndrome) with chronic use
- Secondary infections due to immunosuppression
- Delayed wound healing
- Muscle wasting and weakness
注意事項
Use with extreme caution in patients with diabetes mellitus, renal disease, congestive heart failure, or active infections. Do not stop abruptly if used chronically; the dose must be tapered to avoid an Addisonian crisis (adrenal insufficiency). Avoid ophthalmic use if corneal ulceration is present.
藥物交互作用
Significantly increased risk of severe gastrointestinal ulceration and bleeding.
Dexamethasone induces insulin resistance, antagonizing the hypoglycemic effect of insulin and increasing requirements in diabetic patients.
May induce hepatic enzymes, increasing the metabolism and clearance of dexamethasone.
Increased risk of hypokalemia.
監測
- Clinical signs of disease resolution
- Water intake and urination (PU/PD)
- Appetite and body weight
- Blood glucose levels (especially in predisposed patients)
- Signs of gastrointestinal bleeding (melena, hematemesis)
- ACTH stimulation test (if assessing HPA axis suppression)
藥物動力學
半衰期
吸收
Well absorbed after oral administration. Phosphate and sodium phosphate esters are rapidly absorbed from IM or SC sites.
分佈
Widely distributed throughout the body. Crosses the placenta and enters breast milk. Highly bound to plasma proteins (transcortin and albumin).
代謝
Metabolized primarily in the liver.
排除
Excreted primarily by the kidneys as inactive metabolites.
過量
Acute overdose is rarely life-threatening but may cause significant gastrointestinal upset, profound PU/PD, and panting. Chronic overdosage leads to iatrogenic hyperadrenocorticism (Cushing's syndrome), characterized by alopecia, pot-bellied appearance, muscle wasting, and immunosuppression. Treatment is supportive and requires gradual tapering of the drug.
可用產品
劑型
- Suspension
- Ointment
- Tablets
- Injectable solution
人用標示
- Dexamethasone Sodium Phosphate 0.1% Solution, 5 mL bottles
- Dexamethasone Phosphate 0.05% Ointment, 3.5 gram tubes
各地核准狀態
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儲存與穩定性
Store at room temperature away from light and moisture. Keep containers tightly closed. Do not freeze liquid formulations.
飼主須知
給寵物主人的重要提示：
- 排尿和飲水增加： 您的寵物可能會喝更多的水並需要更頻繁地排尿。請確保牠們隨時有乾淨的飲水，並提供額外的排泄機會。
- 食慾增加： 您的寵物可能會顯得異常飢餓。請避免過度餵食以防止體重增加。
- 喘氣： 狗可能會比平時更常喘氣；這是一種常見且通常無害的副作用。
- 請勿突然停藥： 如果您的寵物已經服用此藥超過幾天，請勿突然停止給藥。必須在獸醫的指導下逐漸減少劑量，讓寵物的身體恢復自身天然的類固醇分泌。
警告： 如果您發現寵物排出黑色柏油狀糞便、嘔吐（尤其是帶血）或極度嗜睡，請立即聯繫您的獸醫，因為這些可能是胃潰瘍的徵兆。
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。