葡萄糖酸銻鈉
葡萄糖酸銻鈉是一種五價銻化合物，主要用於治療犬隻的利什曼原蟲症（Leishmaniasis）。在美國無市售，需透過疾病管制與預防中心（CDC）取得。此藥物具有潛在的嚴重副作用，需謹慎使用。
作用機制: The exact mechanism of action of sodium stibogluconate remains incompletely elucidated. * **Prodrug Hypothesis:** It is widely hypothesized to act as a prodrug, where the pentavalent antimony (SbV) is reduced to the more toxic trivalent antimony (SbIII) within the host macrophage or the parasite itself. * **Bioenergetic Disruption:** It is believed to interfere with the parasite's bioenergetics by reducing **ATP and GTP synthesis** in susceptible *Leishmania* amastigotes, ultimately leading to parasite death.
各物種劑量
- Treatment of cutaneous leishmaniasis · 30-50 mg/kg IV or SC daily · IV/SC · q24h · 3-4 weeks
- Treatment of visceral leishmaniasis · 30-50 mg/kg IV or SC q24h · IV/SC · q24h · one month · Has severe side effects and may not be obtainable in the USA; allopurinol alone is usually used initially.
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
- Pre-existing cardiac arrhythmias
- Significantly impaired renal function
- Previous serious adverse reaction to a dose of stibogluconate
- Severe renal impairment
- Severe hepatic impairment
不良反應
- Increased AST levels
- Pain on injection
- Musculoskeletal pain
- Hemolytic anemia
- Leukopenia
- Vomiting
- Diarrhea
- Pancreatitis
- Myocardial injury and arrhythmias
- Renal toxicity
- Shock
- Sudden death
- Thrombophlebitis (with IV administration)
- Nephrotoxicity
- Hepatotoxicity
- Injection site pain
- Lethargy
藥物相互作用
- Amphotericin B · Increased risk of nephrotoxicity · major
- Allopurinol · Synergistic antileishmanial effect (often used together clinically) · minor
監測
- CBC
- Liver enzymes (especially AST)
- Renal function tests
- ECG (for myocardial injury/arrhythmias)
- Bone marrow cultures for Leishmania
- Clinical efficacy
- Renal function (BUN, Creatinine, SDMA, Urinalysis)
- Hepatic enzymes (ALT, AST, ALP)
- Pancreatic enzymes (cPLI, Lipase)
- ECG (for arrhythmias)
過量
In the unlikely event of a parenterally administered overdose, it is suggested to immediately contact an animal poison control center. * **Chelation Therapy:** Potentially, antimony toxicity can be managed by chelating agents such as **dimercaptosuccinic acid (DMSA)** or **d-penicillamine** to enhance excretion.
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。