奧司他韋
**奧司他韋 (Oseltamivir)** 是一種神經氨酸酶抑制劑抗病毒藥物,主要用於人類**A型和B型流感**的治療與預防。 在獸醫學中,其使用極具爭議且多屬實驗性質: - **犬小病毒 (CPV):** 根據傳聞及有限的研究,它被用作犬小病毒性腸炎的輔助治療。雖然它不能直接殺死小病毒,但理論上能降低病毒穿透腸道黏蛋白層的能力,並減少繼發性細菌移位。 - **馬流感:** 實驗研究顯示,若及早給藥,能有效減輕臨床症狀、減少病毒排泄及預防繼發性細菌性肺炎。 > **公共衛生警告:** 由於奧司他韋 (Tamiflu®) 是人類應對流感大流行 (如 H5N1) 的關鍵第一線防禦藥物,許多專家強烈不建議在獸醫病患身上使用,以保護藥物庫存並防止病毒產生抗藥性。 **法規注意事項:** 美國 FDA 已嚴格**禁止**在雞、火雞和鴨等家禽中標示外使用奧司他韋及其他流感抗病毒藥物。
作用機制: Oseltamivir phosphate is a **prodrug** that is rapidly converted by hepatic esterases into its active metabolite, **oseltamivir carboxylate**. - **Antiviral Action:** It competitively inhibits the **viral neuraminidase enzyme** → prevents the cleavage of sialic acid residues on the host cell surface → halts the release of newly formed viral particles from infected cells and prevents viral aggregation. - **Parvovirus Mechanism (Theoretical):** Canine parvovirus does not possess neuraminidase. However, oseltamivir may inhibit host or bacterial neuraminidases in the GI tract → preserves the protective intestinal mucous layer → limits the ability of CPV to infect intestinal crypt cells and reduces GI bacterial colonization, translocation, and toxin absorption.
各物種劑量
- Treatment of equine Influenza A · 2 mg/kg PO twice daily for 5 days · PO · q12h · 5 days · Must be given early in the course of the disease to obtain satisfactory outcome. Dose based on human pediatric dosage.
- Adjunctive treatment of canine parvovirus enteritis · 2.2 mg/kg PO q12h · PO · q12h · Should be administered as early as possible in the course of the disease. More data is needed to prove efficacy.
- Adjunctive treatment of canine parvovirus enteritis · 2.2 mg/kg PO twice daily for 5 days · PO · q12h · 5 days · To better insure that a vomiting patient will keep the drug down, recommend administering it 30 minutes after a chlorpromazine or other antiemetic injection.
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 oseltamivir
- Poultry (chickens, turkeys, ducks) - FDA banned for extra-label use
不良反應
- Gastrointestinal upset (nausea, vomiting - usually transient)
- Insomnia (reported in humans)
- Vertigo (reported in humans)
藥物相互作用
- Probenecid · May increase 2-fold the exposure to oseltamivir carboxylate (active metabolite) by reducing renal tubular secretion.
- Vaccines, influenza (live) · May potentially reduce the immune response to live influenza virus vaccines. No effect on inactivated (killed) vaccines.
監測
- Clinical efficacy (resolution of clinical signs, weight gain, WBC count maintenance in parvo)
- Gastrointestinal tolerance
過量
Oseltamivir has a relatively **low toxic potential**. In humans, massive overdoses (up to 1000 mg) have primarily caused only gastrointestinal signs such as nausea and vomiting. Treatment should be supportive and symptomatic.
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。