曲恩汀
曲恩汀是一種口服銅螯合劑，主要用於治療犬隻的銅相關性肝病（例如貝林登㹴、拉布拉多犬等易發品種）。當病患無法耐受青黴胺（Penicillamine）的胃腸道副作用（如嚴重嘔吐）時，曲恩汀是極佳的替代選擇。
作用機制: Trientine acts as a polyamine chelating agent. It binds to systemic copper to form a stable, water-soluble complex (a chelate) that is subsequently eliminated from the body via **urinary excretion**. * **Affinity Profile:** Trientine has a greater affinity for **plasma copper** compared to penicillamine. * Conversely, penicillamine has a higher affinity for **tissue copper**. * By binding circulating copper, trientine creates a concentration gradient that gradually pulls stored copper out of hepatic tissues for elimination.
各物種劑量
- As a chelator for copper hepatotoxicity · 10-15 mg/kg · PO · q12h · 1-2 hours before a meal
- As a chelator for copper hepatotoxicity · 10-15 mg/kg · PO · q12h · Give one hour before meals
- As a chelator for copper hepatotoxicity · 15-30 mg/kg · PO · q12h · Give prior to meals
- Copper hepatotoxicosis · 10-15 mg/kg · PO · q12h · Long-term as needed · Vomiting may be reduced by giving in divided doses with food.
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 trientine
- Cystinuria
- Rheumatoid arthritis
- Biliary cirrhosis
- No specific contraindications available in the monograph, but should be used with caution in patients without confirmed copper storage disease.
不良反應
- Acute renal failure (rare but reported in dogs)
- Iron deficiency anemia (with long-term use)
- Topical contact dermatitis (if powder contacts skin)
- Nausea
- Vomiting
- Abdominal pain
- Melaena (dark, tarry stools)
- Weakness
- Copper deficiency (with chronic therapy)
藥物相互作用
- Iron · Iron and trientine mutually inhibit the absorption of one another. Separate doses by at least 2 hours.
- Zinc · Trientine may chelate zinc and other essential minerals, reducing their absorption. Separate doses by at least 2 hours.
- Iron supplements · Inhibits absorption of iron; separate doses by a minimum of 2 hours · moderate
- Zinc supplements · Inhibits absorption of zinc; separate doses by a minimum of 2 hours · moderate
- Other mineral supplements · Inhibits absorption of minerals; separate doses by a minimum of 2 hours · moderate
監測
- Periodic quantitative hepatic copper levels (via liver biopsy)
- Renal function parameters (BUN, Creatinine, SDMA, Urinalysis) due to the risk of acute renal failure
- Complete Blood Count (CBC) to monitor for iron deficiency anemia
- Hepatic copper concentrations (via biopsy)
- Liver enzymes (ALT, AST, ALP)
- Clinical signs of copper deficiency (e.g., anemia, weakness)
- Gastrointestinal tolerance
過量
Little information is available regarding acute toxicity in veterinary species. In human medicine, a case of a patient ingesting 30 grams of trientine without significant morbidity has been reported. If a massive overdose occurs in a pet, standard gastrointestinal decontamination and supportive care are recommended.
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。