地芬諾酯 (複方地芬諾酯)
地芬諾酯是一種合成的**鴉片類促效劑**，主要用作**止瀉**劑。通常與亞治療劑量的**阿托品**（atropine）配製成複方，以防止藥物濫用。 > **警告：** 在感染性腹瀉或產毒性感染中應謹慎使用，因為降低胃腸道蠕動會延遲病原體和毒素的清除。 **臨床提示：** 雖然歷史上用於急性腹瀉，但現代獸醫學通常傾向於解決根本原因或使用益生菌/益生元，僅在特定的難治性病例中使用腸道蠕動調節劑。
作用機制: Diphenoxylate acts locally and centrally on **mu-opioid receptors** in the gastrointestinal tract. * **Increases** intestinal segmental smooth muscle tone. * **Decreases** the propulsive activity (peristalsis) of smooth muscle. * **Decreases** electrolyte and water secretion into the intestinal lumen. → The addition of **atropine** is at a sub-therapeutic dose to cause unpleasant anticholinergic side effects if overdosed, thereby discouraging abuse.
給藥途徑
禁忌症
- Toxigenic diarrhea
- Infectious enteritis (e.g., Salmonella, Parvovirus)
- Obstructive GI disease
- Severe liver disease
- Cats (generally avoided due to CNS excitation/depression)
不良反應
- Constipation
- Sedation
- Bloating
- Paralytic ileus
- CNS depression (especially in cats)
- Anticholinergic effects at high doses (dry mouth, tachycardia)
藥物相互作用
- Monoamine Oxidase Inhibitors (MAOIs) · May cause severe hypertensive crisis · major
- CNS Depressants (e.g., sedatives, anesthetics) · Additive CNS and respiratory depression · moderate
- Anticholinergics · Additive anticholinergic effects and increased risk of severe ileus · moderate
監測
- Fecal output and consistency
- Bowel sounds (auscultation for ileus)
- CNS status (sedation or excitation)
過量
Overdose can lead to severe **CNS depression**, **respiratory depression**, and **paralytic ileus**. Due to the atropine component, anticholinergic signs (tachycardia, dry mucous membranes, mydriasis) may also occur. **Treatment:** Naloxone can be used to reverse the opioid effects. Provide supportive care for anticholinergic toxicity and respiratory depression.
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。