匹羅卡品 / 毛果芸香鹼
匹羅卡品是一種直接作用的副交感神經致效劑，主要用於獸醫眼科。它能刺激膽鹼能受體，導致睫狀肌收縮和縮瞳，從而改善房水排出並降低眼內壓。雖然過去常用於青光眼管理，但現已多被碳酸酐酶抑制劑和前列腺素類似物取代。此外，口服匹羅卡品可用於刺激患有神經性乾眼症（KCS）犬隻的淚液分泌。貓因具有較高的潛在毒性風險，極少使用。
作用機制: Pilocarpine is a direct-acting parasympathomimetic that stimulates **cholinergic (muscarinic) receptors**. In the eye: Stimulates cholinergic receptors → **ciliary body muscle contraction** and **miosis** (pupil constriction) → opens the iridocorneal angle → improved aqueous humour outflow → **decreased intraocular pressure (IOP)**. Systemically/Orally: Stimulates exocrine glands → increased lacrimation and salivation.
各物種劑量
- Management of glaucoma · Not specified in text · topical · Not specified in text · Not specified in text · Produces miosis in 10-15 minutes lasting for 6-8 hours. Most common concentration used in dogs is 1%.
- Neurogenic keratoconjunctivitis sicca (KCS / dry eye) · Not specified in text · PO · Not specified in text · Not specified in text · Increases lacrimation. Topical ophthalmic pilocarpine can also be used for this but can be irritant.
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
- Uveitis
- Anterior lens luxation
不良反應
- Conjunctival hyperaemia (vasodilation)
- Local ocular irritation (due to low pH)
- Salivation
- Lacrimation
- Urinary incontinence
- Gastrointestinal disturbances (vomiting, diarrhea)
- Cardiac arrhythmias
監測
- Intraocular pressure (IOP) if treating glaucoma
- Schirmer tear test (STT) if treating KCS
- Signs of systemic cholinergic toxicity (SLUDGE signs: Salivation, Lacrimation, Urination, Defecation, GI upset, Emesis)
過量
Overdosage or systemic absorption can lead to **cholinergic toxicity** (parasympathomimetic overdrive). **Clinical signs of systemic toxicity include:** - Salivation (drooling) - Excessive lacrimation - Urinary incontinence - Gastrointestinal disturbances (vomiting, diarrhea) - Cardiac arrhythmias
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。