塞替派
塞替派（Thiotepa）是一種強效、非細胞週期特異性的**烷化劑類抗腫瘤藥物**。 在獸醫學中，主要用於： * **體腔內灌注**以控制惡性腫瘤積液（如胸腔或腹腔積液）。 * **膀胱內灌注**治療膀胱移行細胞癌（儘管研究指出其療效明顯低於全身性阿黴素/環磷醯胺療程）。 * 作為多種癌瘤的全身性輔助治療。 > **臨床要點：** 塞替派的治療指數非常狹窄。由於其為危險的細胞毒性藥物，必須嚴格遵守安全操作規範（例如使用生物安全櫃、封閉式傳輸系統及適當的個人防護裝備），以保護獸醫人員免受致突變和致畸胎風險。
作用機制: Thiotepa acts as a polyfunctional alkylating agent. * **Mechanism:** It undergoes conversion to its active metabolite, **TEPA**, which directly cross-links DNA strands by binding to guanine bases. * **Pathway:** DNA cross-linking → interference with DNA replication and RNA transcription → cell cycle arrest and apoptosis. * **Specificity:** It is **cell-cycle non-specific**, meaning it exerts cytotoxic effects on both resting and actively dividing cells. * When administered via the intracavitary route, it is believed to control malignant effusions through a direct, localized antineoplastic effect on the serosal surfaces.
各物種劑量
- Intracavitary use for neoplastic effusions or systemically for adjunctive therapy of carcinomas · 0.2-0.5 mg/m 2 · intracavitary; IV · Not specified · Not specified · Consultation with a veterinary oncologist and referral to current veterinary oncology references are strongly recommended.
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
- Hypersensitivity to thiotepa
- Pregnancy (teratogenic and mutagenic - FDA Category D)
不良反應
- Leukopenia (most common)
- Thrombocytopenia
- Anemia
- Pancytopenia
- Vomiting
- Diarrhea
- Stomatitis
- Intestinal ulceration
- Dizziness (reported in humans)
- Headache (reported in humans)
藥物相互作用
- Immunosuppressive drugs (e.g., azathioprine, cyclophosphamide, corticosteroids) · May increase the risk of severe infections due to additive immunosuppression.
- Myelosuppressive drugs (e.g., chloramphenicol, flucytosine, amphotericin B, colchicine) · Extreme caution required; bone marrow depression may be additive and lead to severe pancytopenia.
- Live Vaccines · Increased risk of vaccine-induced infection or reduced vaccine efficacy; use with extreme caution, if at all.
監測
- Clinical efficacy (tumor response or reduction in effusion)
- CBC with platelets (monitor closely for myelosuppression)
- Serum uric acid levels
過量
There is **no specific antidote** for a thiotepa overdose. Treatment is primarily supportive and symptomatic. If severe hematologic toxicity (profound myelosuppression) occurs, aggressive supportive therapy is required, which may include **transfusions of appropriate blood products**, broad-spectrum prophylactic antibiotics, and isolation to prevent secondary infections.
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。