甘油
**甘油**（Glycerin，又稱 glycerol）是一種強效的口服高滲透壓劑。在獸醫學中，主要用於急診情況下，為患有急性青光眼的病患快速且短期地降低**眼內壓 (IOP)**，偶爾也用於降低腦脊髓液 (CSF) 壓力。 * **主要優勢**：與需要靜脈注射的甘露醇 (mannitol) 不同，甘油可以口服給藥，在眼科急診的臨床使用上非常方便。 * **臨床要點**：由於甘油在肝臟中會代謝為碳水化合物（葡萄糖），會增加熱量負荷並可能顯著升高血糖，因此通常禁忌或極度謹慎用於糖尿病患畜。
作用機制: **Glycerin** exerts its effects purely through physical osmotic forces rather than specific receptor interactions. * **Osmotic Gradient**: When administered orally, it rapidly increases the osmolality of the blood plasma. * **Fluid Shift**: This hyperosmolar state draws water from extravascular spaces (including the aqueous and vitreous humor of the eye, and cerebrospinal fluid) into the intravascular space → **Decreased IOP** and **Decreased CSF pressure**. * **Metabolism**: Once in the liver, glycerin is metabolized via the enzyme **glycerol kinase** → glycerol-3-phosphate → enters glycolysis and gluconeogenesis pathways.
各物種劑量
- Acute glaucoma · 1-2 g/kg PO as a 50% oral solution · PO · single dose
- Acute glaucoma · 1-2 mL/kg (of a 90% solution) PO · PO · single dose · Withhold water for 3-4 hours after administration.
- Acute glaucoma (emergency reduction of IOP) · 1.1-2.2 mL/kg (0.5-1 mL/lb) of 90% syrup · PO · single dose · Mix with an equal volume of ice cream or milk to help reduce vomiting.
- Acute glaucoma · 1-2 g/kg PO as a 50% oral solution · PO · single dose
- Acute glaucoma · 1-2 mL/kg (of a 90% solution) PO · PO · single dose · Withhold water for 3-4 hours after administration.
- Acute glaucoma (emergency reduction of IOP) · 1.1-2.2 mL/kg (0.5-1 mL/lb) of 90% syrup · PO · single dose · Mix with an equal volume of ice cream or milk to help reduce vomiting.
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
- Known hypersensitivity to glycerin
- Well-established anuria
- Severe dehydration
- Severe cardiac decompensation
- Frank or impending acute pulmonary edema
- Diabetes mellitus (relative/absolute depending on source)
- Chronic renal failure or compromised renal function
不良反應
- Vomiting (most common)
- Headache (reported in humans)
- Nausea
- Thirst
- Diarrhea
藥物相互作用
- Carbonic anhydrase inhibitors (e.g., acetazolamide, dichlorphenamide) · Concomitant administration may prolong the IOP-reducing effects of glycerin.
- Topical miotic agents · Concomitant administration may prolong the IOP-reducing effects of glycerin.
監測
- Intraocular pressure (IOP)
- Urine output
- Hydration status
過量
Specific veterinary overdose information is limited. However, **cardiac arrhythmias**, **non-ketotic hyperosmolar coma**, and **severe dehydration** have been reported with the drug. Treatment should be supportive and symptomatic, focusing on restoring fluid and electrolyte balance.
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。