麩醯胺酸
麩醯胺酸是一種**條件性必需胺基酸**,在維持胃腸道、免疫系統、腎臟和肝臟的健康與完整性方面扮演著關鍵角色。 雖然健康且蛋白質攝取充足的動物能在骨骼肌中合成足夠的麩醯胺酸,但處於嚴重代謝壓力下(如重症、嚴重創傷或接受化療)的病患,其消耗量可能會超過生成量。這種消耗會導致進行性肌肉萎縮,並損害腸道黏膜屏障,造成腸道上皮萎縮、潰瘍或壞死。 **臨床重點:** - 主要作為**胃腸道保護劑**,用於促進小腸病毒感染、化療引起的腸炎及胰臟炎等情況下的黏膜癒合。 - **臨床提示:** 麩醯胺酸是腸上皮細胞和結腸細胞首選的呼吸燃料。補充的目的是直接滋養這些細胞並維持腸道屏障功能,防止細菌移位。 - 通常非常安全且安全範圍廣,儘管在獸醫學中的臨床療效數據仍褒貶不一(例如,部分研究顯示對貓的甲氨蝶呤誘導性腸炎無顯著益處)。
作用機制: Glutamine serves multiple vital physiological functions: - **Enterocyte Fuel:** It is the primary metabolic fuel for rapidly dividing cells, particularly intestinal enterocytes and immune cells (lymphocytes, macrophages). Glutamine is metabolized via **glutaminase** to glutamate, which is then converted to alpha-ketoglutarate to enter the **TCA (Krebs) cycle** for ATP production. - **Precursor Molecule:** It acts as a crucial nitrogen donor and precursor for the synthesis of **glutathione** (a major intracellular antioxidant), purines, pyrimidines, and other amino acids. - **Mucosal Integrity:** By providing direct energy to the gut lining, it stimulates intestinal cell proliferation and differentiation, helping to maintain tight junctions and prevent increased intestinal permeability ("leaky gut") during times of severe stress or mucosal injury.
各物種劑量
- Adjunctive treatment of GI inflammatory conditions · 0.5 grams/kg PO daily · PO · q24h
- Adjunctive treatment of GI inflammatory conditions · 0.5 gram/kg/day PO divided twice a day · PO · q12h · Administer in water or food
- Adjunctive treatment of GI inflammatory conditions (for animals not eating) · 0.5 grams/kg per day divided into 2-3 doses · PO · q8-12h · Dissolved in drinking water
- Adjunctive treatment of GI inflammatory conditions · 0.5 grams/kg PO daily · PO · q24h
- Adjunctive treatment of GI inflammatory conditions · 0.5 gram/kg/day PO divided twice a day · PO · q12h · Administer in water or food
- Adjunctive treatment of GI inflammatory conditions (for animals not eating) · 0.5 grams/kg per day divided into 2-3 doses · PO · q8-12h · Dissolved in drinking water
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
- Severe hepatic insufficiency
- Severe behavior disorders
- Epilepsy or seizure disorders
不良反應
- Generally well tolerated
- Potential CNS effects at very high dosages
- Increased serum ammonia or glutamate levels
藥物相互作用
- Anticonvulsant medications (e.g., phenobarbital, potassium bromide) · Glutamine could potentially decrease the efficacy of antiseizure medications because it is partially converted into glutamate, which acts as an excitatory neurotransmitter in the CNS.
- Lactulose · Theoretically, glutamine may antagonize the ammonia-lowering effects of lactulose in patients being treated for hepatic encephalopathy.
監測
- Clinical efficacy (improvement in GI signs, weight maintenance)
- Serum ammonia levels (in patients with compromised liver function)
- Serum glutamate levels
過量
Overdosages are unlikely to be harmful in healthy animals. In humans, intravenous doses of up to 40 grams per day have been tolerated without ill effects. However, because glutamine is partially metabolized to ammonia, patients with pre-existing hepatic insufficiency (liver disease) may be adversely affected and could develop signs of hepatic encephalopathy.
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。