泊那珠利
泊那珠利 (Ponazuril) 是一種經 FDA 批准的三嗪類抗原蟲藥物，主要用於治療由神經肉孢子蟲 (*Sarcocystis neurona*) 引起的馬原蟲性脊髓腦炎 (EPM)。 **臨床重點：** - 它是妥曲珠利 (toltrazuril) 的活性代謝物。 - 雖然標籤適應症為馬，但由於其療效佳且相對安全，越來越多被標籤外用於小動物、特寵和反芻動物，治療球蟲病、新孢子蟲病和弓形蟲病。 - 它能穿透血腦屏障，因此對中樞神經系統的原蟲感染有效。
作用機制: Ponazuril targets the **apicoplast** (plastid body), an essential organelle found specifically in members of the Apicomplexa phylum (which includes *Sarcocystis*, *Toxoplasma*, *Neospora*, and *Eimeria*). Inhibition of the apicoplast → Disruption of the organism's ability to synthesize essential fatty acids and amino acids → **Protozoal death** (cidal activity).
各物種劑量
- Neosporosis or Toxoplasmosis · 7.5-15 mg/kg PO once daily · PO · q24h · 28 days · Dose extrapolated between doses for horses and mice.
- Coccidiosis · 20 mg/kg PO daily · PO · q24h · 3 days · Must be compounded for administration in kittens or cats. Associated with rapid resolution of diarrhea.
- Equine Protozoal Myeloencephalitis (EPM) · 5 mg/kg PO once daily · PO · q24h · 28 days · See package insert for specific dosing instructions.
- Cryptosporidium respiratory disease (Falcons) · 20 mg/kg PO once daily · PO · q24h · 7 days · Given as a compounded suspension.
- Adjunctive treatment of Eimeria species (Rabbits) · 20 mg/kg PO q24h · PO · q24h · 7 days
- Eimeria macusaniensis (Camelids/Crias) · 20 mg/kg PO once daily · PO · q24h · 3 days · Dilute paste to 100 mg/mL before administration (e.g., 40g paste + distilled water to 60g total).
- Neosporosis or Toxoplasmosis · 7.5-15 mg/kg PO once daily · PO · q24h · 28 days · Dose extrapolated between doses for horses and mice.
- Coccidiosis · 15-30 mg/kg PO once or repeated after 7-10 days · PO · once or repeated after 7-10 days · 1-2 doses · Anecdotal
- Coccidians (Bearded dragons) · 30 mg/kg PO twice 48 hours apart · PO · q48h · 2 doses
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
- No absolute contraindications noted, but other causes of ataxia should be ruled out before treating for EPM.
不良反應
- Blisters on nose and mouth
- Rash or hives
- Diarrhea or loose feces
- Mild colic
- Seizures (rare)
- Keratoconjunctivitis sicca (KCS) in dogs (especially predisposed breeds or at high doses)
監測
- Clinical efficacy and resolution of neurological or gastrointestinal signs
- Tear production (Schirmer Tear Test) in dogs, especially predisposed breeds
過量
In horses, daily doses of up to 30 mg/kg (6X the normal dose) primarily caused loose feces. Moderate edema of the uterine epithelium was noted on histopathology for female horses receiving the 6X dose. In dogs, overdose quantities have been associated with the development of Keratoconjunctivitis sicca (KCS).
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