氟米松

各物種劑量

給藥途徑

禁忌症

• Last trimester of pregnancy (may induce parturition)
• Systemic fungal infections (unless used for Addison's replacement therapy)
• Idiopathic thrombocytopenia (specifically contraindicated for IM administration)
• Known hypersensitivity to the compound
• Chronic corticosteroid therapy of systemic diseases using sustained-release injectable forms

不良反應

• Polydipsia (PD), polyuria (PU), and polyphagia (PP)
• Weight gain and lipidemias
• Dull, dry haircoat and dermatological thinning
• Panting
• Gastrointestinal effects: vomiting, diarrhea, GI ulceration
• Hepatopathy: elevated liver enzymes (ALP, ALT)
• Pancreatitis
• Endocrine: activation or worsening of diabetes mellitus, iatrogenic hyperadrenocorticism (Cushingoid effects) with sustained use
• Musculoskeletal: muscle wasting, retarded growth in young animals
• Behavioral changes: depression, lethargy, viciousness
• Immunosuppression: increased susceptibility to infections

藥物相互作用

• Amphotericin B · Administered concomitantly with glucocorticoids may cause hypokalemia
• Anticholinesterase agents (e.g., pyridostigmine, neostigmine) · In patients with myasthenia gravis, concomitant administration may lead to profound muscle weakness. Discontinue anticholinesterase at least 24 hours prior if possible.
• Aspirin · Glucocorticoids may reduce salicylate blood levels
• Barbiturates · May increase the metabolism of glucocorticoids and decrease flumethasone blood levels
• Cyclophosphamide · Glucocorticoids may inhibit the hepatic metabolism of cyclophosphamide; dosage adjustments may be required
• Cyclosporine · Concomitant administration may increase the blood levels of each by mutually inhibiting hepatic metabolism
• Diazepam · Flumethasone may decrease diazepam levels
• Diuretics, potassium-depleting (e.g., spironolactone, triamterene) · Administered concomitantly with glucocorticoids may cause hypokalemia
• Ephedrine · May reduce flumethasone blood levels
• Insulin · Insulin requirements may increase in patients receiving glucocorticoids
• Ketoconazole and other azole antifungals · May decrease the metabolism of glucocorticoids and increase flumethasone blood levels; ketoconazole may induce adrenal insufficiency when glucocorticoids are withdrawn

監測

• Weight, appetite, and signs of edema
• Serum and/or urine electrolytes
• Total plasma proteins, albumin
• Blood glucose
• Growth and development in young animals
• ACTH stimulation test if necessary (to assess adrenal axis suppression)

過量

Short-term administration of massive dosages of glucocorticoids is unlikely to cause harmful effects. There is one reported incidence of a dog developing acute CNS effects after accidental ingestion. If acute clinical signs occur, provide supportive treatment as required. Chronic overdosage or sustained high-dose usage leads to serious adverse effects, primarily manifesting as iatrogenic hyperadrenocorticism (Cushing's syndrome), characterized by severe polyuria/polydipsia, muscle wasting, alopecia, pot-bellied appearance, and immunosuppression.