3% 過氧化氫 (雙氧水)
3% 過氧化氫是一種廣泛使用的局部抗菌劑，在獸醫學中常被用作**緊急口服催吐劑**，主要用於犬隻。 * **臨床要點：** 雖然它是家庭常備用品，但作為催吐劑通常僅限於無法立即獲得獸醫治療且需要快速去毒的情況。在臨床環境中，首選中樞性催吐劑如**阿朴嗎啡 (apomorphine)**（犬用）或**甲苯噻嗪/右美托咪定 (xylazine/dexmedetomidine)**（貓用），因為它們的療效更高且引起嚴重黏膜刺激的風險較低。 * **貓咪注意事項：** 毒理學家越來越不建議在貓身上使用，因為有引發嚴重壞死性出血性胃炎的高風險。 * **療效：** 成功誘發嘔吐並不能保證胃內容物已完全排空；攝入的藥物/毒素可能仍有大量殘留或已被吸收。
作用機制: Orally administered hydrogen peroxide (3%) induces a vomiting reflex via direct irritant effects on the oropharynx and gastric lining. * **Mechanism:** H₂O₂ interacts with the enzyme **catalase** present in tissue and blood → rapid release of water (H₂O) and oxygen gas (O₂) → massive bubbling and gastric distension. * The combination of direct mucosal irritation and sudden gastric distension stimulates visceral afferent vagal and sympathetic nerves → signals the **emetic center** in the medulla oblongata → triggers the vomiting reflex. * Emesis typically ensues within 10 minutes of administration.
各物種劑量
- As an emetic · 1 teaspoon (5 mL) per 5 lbs. (2.3 kg) of body weight (approximately 2 mL/kg) not to exceed 3 tablespoons (45 mL). · PO · can be repeated once if not initially successful · Vomiting usually occurs within minutes. Note: Use in cats is generally discouraged due to risk of severe gastric ulceration.
- As an emetic · 1-2 mL/kg PO up to 2-3 times · PO · up to 2-3 times
- As an emetic · 1-5 mL/kg PO; generally not to exceed 50 mL for dogs and 10 mL for cats; may repeat one time if after 10 minutes emesis does not occur. · PO · may repeat one time if after 10 minutes emesis does not occur · Inducing emesis is most effective if administered after a small meal.
- As an emetic · 1 teaspoon (5 mL) per 5 lbs. (2.3 kg) of body weight (approximately 2 mL/kg) not to exceed 3 tablespoons (45 mL). · PO · can be repeated once if not initially successful · Vomiting usually occurs within minutes.
- As an emetic · 1-2 mL/kg PO up to 2-3 times · PO · up to 2-3 times
- As an emetic · 1-5 mL/kg PO; may repeat one time if after 10 minutes emesis does not occur. · PO · may repeat one time if after 10 minutes emesis does not occur · Inducing emesis is most effective if administered after a small meal.
- As an emetic (pot-bellied pigs) · 1 teaspoon (5 mL) per 5 lbs. (2.3 kg) of body weight (approximately 2 mL/kg) not to exceed 3 tablespoons (45 mL). · PO · can be repeated once if not initially successful · Vomiting usually occurs within minutes.
給藥途徑
禁忌症
- Animals already vomiting
- Severely lethargic, comatose, or debilitated animals (e.g., respiratory distress, decreased swallowing reflex, bradycardia)
- Seizuring or hyperactive animals
- Recent abdominal surgery
- Megaesophagus
- Ingestion of corrosives/caustics (e.g., acids, alkalis)
- Ingestion of sharp objects
- Ingestion of bagged illicit drugs
- Ingestion of hydrocarbons or petroleum distillates
- Rodents or rabbits (incapable of vomiting)
不良反應
- Aspiration of hydrogen peroxide solution or stomach contents
- Vasovagal (bradycardic) response in animals with cardiovascular compromise
- Gastric ulceration (particularly in cats)
- Gastric-dilatation-volvulus (GDV) in dogs
藥物相互作用
- ACETYLCYSTEINE (oral) · Hydrogen peroxide can oxidize acetylcysteine in the gut; alternative emetics are preferred for acetaminophen overdoses.
- ANTIEMETICS (e.g., ondansetron, maropitant) · Preadministration or ingestion of these products may negate the emetic effects of hydrogen peroxide.
監測
- Efficacy (emesis, signs associated with toxicity of the substance ingested, blood levels of toxicants if applicable)
- Heart rate and respiration rate
- Thoracic auscultation after emesis (to monitor for aspiration pneumonia)
過量
Hydrogen peroxide 3% solution is relatively non-toxic after oral ingestion, though it can cause gastric irritation, vomiting, and rarely gastric ulceration or GDV. > **DANGER:** Hydrogen peroxide in concentrations of **10% or greater** (such as hair bleach or industrial peroxide) can be very corrosive, causing severe burns to the oral and gastric mucosa, and can induce fatal oxygen emboli after oral ingestion.
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