依滅丁與吡喹酮 (Emodepside and Praziquantel)
**依滅丁/吡喹酮**（常見商品名為 Profender® 滴即除）是一種廣效、局部外用的抗寄生蟲複方藥物，主要用於貓咪。 * **依滅丁 (Emodepside)** 是一種新型的環八縮酚酸肽，對線蟲（蛔蟲和鉤蟲）具有極佳的療效。 * **吡喹酮 (Praziquantel)** 是一種廣泛使用的異喹啉-吡嗪衍生物，對絛蟲具有高度療效。 **臨床要點：** * 局部滴劑的劑型對於難以餵食口服藥的貓咪患者具有顯著優勢，能大幅減少寵物與飼主的壓力。 * 雖然標示用於貓咪，但在特寵醫學中也常被標示外使用（off-label），特別是在難以口服給藥的爬蟲類動物。 * 藥物會經由皮膚吸收至全身；因此，防止動物舔舐塗抹部位對於避免腸胃不適及確保正確劑量至關重要。
作用機制: The combination utilizes two distinct mechanisms to eradicate parasites: * **Emodepside (Nematocide):** Binds pre-synaptically at the neuromuscular junction to a **latrophilin-like receptor** → increases intracellular calcium and diacylglycerol → triggers fusion of vesicles containing inhibitory neuropeptides → releases **PF1- and/or PF2-like receptors** into the synaptic cleft → stimulates postsynaptic receptors. This cascade results in the profound inhibition of pharyngeal pumping and locomotion, leading to **flaccid paralysis and death** of the nematode. * **Praziquantel (Cestocide):** Interacts with phospholipids in the parasite's integument → causes rapid intracellular ion fluxes (sodium, potassium, and **calcium**) → induces severe, irreversible tetanic contraction of the worm's musculature. At higher concentrations, it causes irreversible focal vacuolization and subsequent disintegration of the cestodal integument, making the parasite susceptible to the host's immune system.
各物種劑量
- Treatment and control of hookworm, roundworm, and tapeworm infections · Minimum dose is 3 mg/kg emodepside & 12 mg/kg praziquantel applied to the skin on the back of the neck as a single topical dose. If re-infection occurs, the product can be re-applied after 30 days. · topical · once · Single dose · A second treatment should not be necessary unless re-infection occurs.
- Parasitic infections (off-label) · 4 drops/100 g body weight · topical · once · Single dose · Aquatic species must be kept in a dry place for 48 hours after treatment. Caution is advised until further studies verify safety and efficacy, particularly in sick animals.
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
- Cats less than 8 weeks of age
- Cats weighing less than 1 kg (2.2 lb)
不良反應
- Application site reactions (alopecia, dermatitis, pyoderma, edema, erythema, pruritus)
- Salivation/hypersalivation (especially if licked)
- Lethargy
- Vomiting
- Diarrhea
- Agitation or nervousness
- Tremors or twitching
- Ataxia
- Eye or respiratory irritation
- Rare post-approval reports: facial swelling, rear leg paralysis, seizures, hyperesthesia, morphea-like (scleroderma) lesion
藥物相互作用
- P-glycoprotein inhibitors/substrates (e.g., ivermectin, erythromycin, prednisolone, cyclosporine) · Emodepside is a P-glycoprotein substrate; concurrent use may cause pharmacokinetic interactions and potentially increase toxicity or alter efficacy.
監測
- Clinical efficacy (resolution of clinical signs, negative fecal flotation/sedimentation)
過量
Both drugs generally have a wide margin of safety. * **Topical Overdose:** In 8-week-old kittens treated topically at 5X the recommended dose, transient salivation and/or tremors were observed but were self-limiting. In 7- to 8-month-old cats treated at 10X the dose, transient salivation, tremor, and lethargy occurred. * **Oral Exposure:** Accidental oral ingestion (e.g., licking the application site) can cause salivation, vomiting, anorexia, tremors, abnormal respirations, and ataxia. These signs typically resolve without specific treatment. * **Praziquantel Toxicity:** Parenteral doses of 50-100 mg/kg in cats caused transient ataxia and depression; injected doses of 200 mg/kg were lethal.
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。