氫化可的松
被認為是一種低效局部皮質類固醇，氫化可的松可用於局部瘙癢和/或炎症的輔助治療。與高效皮質類固醇相比，其風險顯著較低，是治療大面積或小型患者的合理首選。
作用機制: Corticosteroids are non-specific anti-inflammatory agents. They act by inducing **phospholipase A2 inhibitory proteins (lipocortins)** in cells → reducing the formation, activity, and release of endogenous inflammatory mediators (e.g., **histamine, prostaglandins, kinins**). They also reduce DNA synthesis via an anti-mitotic effect on epidermal cells and inhibit the migration of leukocytes and macrophages to the area, reducing erythema, pruritus, and edema.
各物種劑量
- Focal or multifocal pruritic/inflammatory lesions · Initially used sparingly 1-4 times per day and then frequency is tapered when control is achieved. Shampoos: once a day to once a week (leave on 10 mins). · topical · q6-24h · < 2 months
- Focal or multifocal pruritic/inflammatory lesions · Initially used sparingly 1-4 times per day and then frequency is tapered when control is achieved. Shampoos: once a day to once a week (leave on 10 mins). · topical · q6-24h · < 2 months
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
- Tuberculosis of the skin
- Pregnancy (relative contraindication)
- Pregnant animals
- Renal disease (systemic use generally contraindicated)
- Diabetes mellitus (systemic use generally contraindicated)
不良反應
- Skin atrophy (with long-term use)
- Skin fragility
- Superficial follicular cysts (milia)
- Comedones
- HPA axis suppression (rare, but possible with long-term use)
- Weight loss (catabolic effect)
- Cutaneous atrophy
- Iatrogenic hyperadrenocorticism (PU/PD, elevated liver enzymes)
- Vomiting
- Diarrhoea
- Gastrointestinal ulceration
- Increased urine glucose levels
- Decreased serum T3 and T4 values
- Hypothalamic-pituitary axis suppression (with prolonged use)
- Adrenal atrophy
- Impaired wound healing
藥物相互作用
- NSAIDs · Increased risk of gastrointestinal ulceration · major
- Insulin · Glucocorticoids antagonize the effect of insulin · major
- Phenobarbital · May accelerate the metabolism of corticosteroids · moderate
- Itraconazole · May decrease the metabolism of corticosteroids · moderate
- Acetazolamide · Increased risk of hypokalaemia · moderate
- Amphotericin B · Increased risk of hypokalaemia · major
- Furosemide · Increased risk of hypokalaemia · moderate
- Thiazide diuretics · Increased risk of hypokalaemia · moderate
監測
- Resolution of clinical signs (pruritus, erythema)
- Signs of skin atrophy or secondary infection
- Serum electrolytes (especially Sodium and Potassium)
- Liver enzymes
- Blood and urine glucose
- Clinical signs of GI ulceration
- Thyroid panel (T3, T4) if indicated
過量
Overdose via topical application is unlikely, but chronic overuse can lead to iatrogenic hyperadrenocorticism (Cushing's syndrome) and HPA axis suppression.
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。