熊去氧膽酸
熊去氧膽酸 (UDCA) 是一種親水性膽汁酸，主要用於治療肝膽疾病。它能保護肝細胞免受有毒疏水性膽汁酸的損害，促進膽汁流動（利膽作用），並具有免疫調節和抗細胞凋亡的特性。 **臨床提示：** 對慢性肝炎、膽管炎和膽囊泥沙非常有效。 > **警告：** 禁忌用於完全性膽道阻塞的病患。
作用機制: UDCA is a hydrophilic bile acid that **inhibits ileal absorption** of toxic, hydrophobic bile acids → reduces their concentration in the systemic bile acid pool. Hydrophobic bile acids are toxic to hepatobiliary cell membranes and potentiate cholestasis. UDCA also stimulates **biliary secretion** (choleretic effect), protects hepatocyte membranes from detergent effects, and exerts **immunomodulatory** and **anti-apoptotic** effects on liver cells.
各物種劑量
- Hepatobiliary disease / Cholestasis · 10-15 mg/kg · PO · q24h or divided q12h · Long-term · Administer with food to enhance absorption.
- Hepatobiliary disease / Cholangitis · 10-15 mg/kg · PO · q24h or divided q12h · Long-term · Administer with food to enhance absorption.
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
- Complete extrahepatic biliary obstruction
- Biliary fistulas
- Severe acute hepatitis
- Cholecystitis
不良反應
- Mild gastrointestinal upset (diarrhea, vomiting)
- Hepatotoxicity (rare, typically only if administered during biliary obstruction)
藥物相互作用
- Aluminum-based antacids · May bind to UDCA in the GI tract, decreasing its absorption and efficacy. · moderate
- Cholestyramine · Binds to UDCA, significantly decreasing its absorption. · major
- Colestipol · Binds to UDCA, significantly decreasing its absorption. · major
監測
- Liver enzymes (ALT, AST, ALP, GGT)
- Total bilirubin
- Serum bile acids
- Clinical signs of liver disease (jaundice, vomiting, lethargy)
過量
Acute overdosage is unlikely to cause severe toxicity but may result in diarrhea. Treatment is symptomatic and supportive.
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