ジゴキシン
別称: Lanoxin, Cardoxin, Lanoxin PG
薬の分類: Cardiac Glycoside
ジゴキシンは、心臓のポンプ機能を助け、不規則な心拍をコントロールするために使用される強力な心臓薬です。 * **厳密な投薬：** 処方された通りに正確に投薬してください。有効量と中毒量の差が非常に小さいため、獣医師に相談せずに用量を変更したり、投薬を中止したりしないでください。 * **中毒症状に注意：** ペットに中毒の兆候（通常は胃腸の不調から始まります）が見られた場合は、すぐに獣医師に連絡してください。**食欲不振、嘔吐、下痢、無気力、気分の落ち込み、行動の変化**に注意してください。 * **投薬を忘れた場合：** 投薬を忘れた場合でも、次回の投薬時に2回分を与えないでください。次の予定時刻に通常の1回分を与えてください。 * **定期的なモニタリング：** 薬の量が安全で効果的であることを確認するため、血液中のジゴキシン濃度、腎機能、電解質レベルをチェックする定期的な血液検査が必要になります。
用量はペットの状態に応じて獣医師が決定します。獣医師の指導なしに人用医薬品や他のペットの処方薬を与えないでください。
Veterinary professional? See the full dosing-by-species reference on VetSheet →
使用用途
- Dilated cardiomyopathy or advanced atrioventricular valve insufficiency
- Starting dose for normal cats weighing less than 3 kg
- Starting dose for normal cats weighing 3 to 6 kg
- Starting dose for normal cats weighing more than 6 kg
- Management of supraventricular tachyarrhythmias
- Management of supraventricular tachyarrhythmias (Emergency/Rare)
- Dilated cardiomyopathy
- Maintenance
- Dilated cardiomyopathy long-term maintenance
- Loading dose
- Maintenance Dose
- Emergency stabilization
- Dilated cardiomyopathy in Hamsters
- Normalize atrial rate
- CHF with atrial fibrillation in dogs with normal renal function
- Initial dosing for dogs weighing less than 20 kg
- Initial dosing for dogs weighing more than 20 kg
- Adjunctive treatment of dilated cardiomyopathy patients with atrial fibrillation
- Adjunctive treatment of atrial fibrillation
- Refractory heart failure or atrial fibrillation (if pimobendan unavailable)
- Supraventricular arrhythmias
- Management of supraventricular tachyarrhythmias
- Management of supraventricular tachyarrhythmias (Emergency/Rare)
投与方法
POIV
考えられる副作用
- Cardiac arrhythmias (complete or incomplete heart block, bigeminy, ST segment changes, paroxysmal ventricular or atrial tachycardias, multifocal VPCs)
- Mild GI upset
- Anorexia
- Weight loss
- Diarrhea
- Vomiting (especially associated with IV injections)
- Vomiting
- Diarrhoea
- Depression
- Arrhythmias (AV block, bigeminy, paroxysmal ventricular or atrial tachycardias with block, multiform VPCs)
- Vasoconstriction (with IV administration)
注意事項と禁忌
- Ventricular fibrillation
- Digitalis intoxication
- Hypertrophic cardiomyopathy in cats (relative contraindication, may increase myocardial oxygen demand and dynamic outflow obstruction)
- Frequent ventricular arrhythmias
- Atrioventricular (AV) block
- Feline hypertrophic cardiomyopathy
- Hypokalaemia
- > **Extreme Caution:** Patients with glomerulonephritis and heart failure, or with idiopathic hypertrophic subaortic stenosis (IHSS). * **Caution:** Severe pulmonary disease, hypoxia, acute myocarditis, myxedema, acute myocardial infarction, frequent VPCs, V-tach, chronic constrictive pericarditis, or incomplete AV block. * **Renal Disease:** Principally eliminated by the kidneys; use with caution and monitor serum levels closely in patients with renal impairment. * **Electrolyte/Endocrine Imbalances:** Animals that are hypernatremic, hypokalemic, hypercalcemic, hyper- or hypothyroid may require smaller dosages; monitor carefully. * **Cardioversion:** Elective cardioversion of patients with atrial fibrillation should be postponed until digoxin has been withheld for 1-2 days. * **Dosing Weight:** Dosing is generally based upon **lean body weight** as digoxin does not distribute well into ascitic fluid or fat.
薬物相互作用
- Aminosalicylic Acid: May reduce digoxin serum levels
- Antacids: May reduce digoxin serum levels
- Chloramphenicol: May reduce digoxin serum levels in dogs
- Cholestyramine: May reduce digoxin serum levels
- Cimetidine: May reduce digoxin serum levels
- Metoclopramide: May reduce digoxin serum levels
- Neomycin (Oral): May reduce digoxin serum levels
- Phenobarbital: May reduce digoxin serum levels
- St John's Wort: May reduce digoxin serum levels
- Sucralfate: May reduce digoxin serum levels
- Sulfasalazine: May reduce digoxin serum levels
- Amiodarone: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Anticholinergics: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Captopril (or other ACEIs): May increase serum levels, decrease elimination rate, or enhance toxic effects
- Coleus: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Cyclosporine: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Diazepam: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Diltiazem: May increase serum levels (data conflicts); additive negative effects on AV conduction
- Erythromycin: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Furosemide: May increase serum levels, decrease elimination rate, or enhance toxic effects; hypokalemia predisposes to digitalis toxicity
- Hawthorn: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Ketoconazole/Itraconazole: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Omeprazole (or other PPIs): May increase serum levels, decrease elimination rate, or enhance toxic effects
- Quinidine: May increase serum levels; rule of thumb is to decrease digoxin dose by 50% if used together
- Reserpine: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Succinylcholine: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Tetracycline: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Verapamil: May increase serum levels; additive negative effects on AV conduction
- Beta-Blockers: Additive negative effects on AV conduction, complete heart block possible
- Penicillamine: May decrease serum levels of digoxin independent of route of digoxin dosing
- Potassium/Electrolyte altering drugs (e.g., amphotericin B, glucocorticoids, laxatives, insulin): May predispose the patient to digitalis toxicity via electrolyte imbalances (e.g., hypokalemia)
- Spironolactone: May enhance or decrease the toxic effects of digoxin
- Thyroid Supplements: Patients on digoxin that receive thyroid replacement therapy may need their digoxin dosage adjusted
- Chemotherapy agents (cyclophosphamide, cytarabine, doxorubicin, vincristine): May decrease digoxin absorption from the GI tract
- Antimuscarinics: May increase serum level, decrease elimination rate, or enhance toxic effects
- Loop and thiazide diuretics: Can cause hypokalaemia, which strongly predisposes to digoxin toxicity
- Oxytetracycline: May increase serum level, decrease elimination rate, or enhance toxic effects
- Cyclophosphamide: May decrease digoxin absorption from the GI tract
- Cytarabine: May decrease digoxin absorption from the GI tract
- Doxorubicin: May decrease digoxin absorption from the GI tract
- Vincristine: May decrease digoxin absorption from the GI tract
- Loop diuretics: May cause hypokalaemia, which enhances the toxic effects of digoxin
- Thiazide diuretics: May cause hypokalaemia, which enhances the toxic effects of digoxin
よくある質問
ジゴキシンはペットにどう使われていますか？
ジゴキシンは、心臓のポンプ機能を助け、不規則な心拍をコントロールするために使用される強力な心臓薬です。 • 厳密な投薬： 処方された通りに正確に投薬してください。有効量と中毒量の差が非常に小さいため、獣医師に相談せずに用量を変更したり、投薬を中止したりしないでください。 • 中毒症状に注意： ペットに中毒の兆候（通常は胃腸の不調から始まります）が見られた場合は、すぐに獣医師に連絡してください。食欲不振、嘔吐、下痢、無気力、気分の落ち込み、行動の変化に注意してください。 • 投薬を忘れた場合： 投薬を忘れた場合でも、次回の投薬時に2回分を与えないでください。次の予定時刻に通常の1回分を与えてください。 • 定期的なモニタリング： 薬の量が安全で効果的であることを確認するため、血液中のジゴキシン濃度、腎機能、電解質レベルをチェックする定期的な血液検査が必要になります。
ジゴキシンはうちのペットに安全ですか？
用量はペットの状態に応じて獣医師が決定します。獣医師の指導なしに人用医薬品や他のペットの処方薬を与えないでください。
この記事は一般的な健康教育を目的としており、専門的な獣医学的アドバイスの代わりにはなりません。ペットが調子悪い場合は、獣医師にご相談ください。