布托啡諾

用途

• As an analgesic
• As a postoperative CRI
• As an epidural analgesic
• As reversal agent for mu-agonist opiates
• In combination as an immobilizing agent (short procedures)
• In combination as an immobilizing agent (more sedation)
• As a sedative/analgesic
• For injectable anesthesia
• Immobilization combinations
• As an analgesic
• For post-op analgesia (CRI)
• As an analgesic for surgery in adult cattle
• As an analgesic

給藥方式

可能的副作用

• Sedation and ataxia
• Anorexia or diarrhea (rare in small animals)
• Respiratory depression (mild compared to pure agonists)
• CNS excitement, head tossing, and increased ambulation (especially in horses at high doses or rapid IV administration)
• Decreased gastrointestinal motility and potential ileus (horses)
• Nystagmus, salivation, seizures, and hyperthermia (at massive overdoses in horses)

注意事項與禁忌

• Known hypersensitivity to butorphanol
• Lower respiratory tract conditions with copious mucous production (suppressing cough prevents clearance)
• Caution in patients with head trauma, increased CSF pressure, or severe CNS dysfunction (e.g., coma)
• Caution in severe liver disease, renal insufficiency, hypothyroidism, or Addison's disease
• Caution in dogs with heartworm disease (safety not established)
• **MDR1 (ABCB1) Mutation Warning**: Dogs with the MDR1 mutation (e.g., Collies, Australian Shepherds) may develop pronounced and prolonged sedation. Reduce the dose by 25% in heterozygous dogs and by 30-50% in homozygous mutant dogs. **Geriatric/Debilitated Patients**: Use with caution and consider dose reductions. **Hepatic/Renal Impairment**: The manufacturer advises against use in dogs with a history of liver disease. Use cautiously in renal insufficiency. **Pregnancy/Nursing**: Category C (human). Safe for use if used cautiously in dogs/cats, but manufacturer does not recommend use in pregnant bitches, foals, weanlings, or breeding horses.

藥物相互作用

• Other CNS Depressants (anesthetics, antihistamines, phenothiazines, barbiturates, tranquilizers): May cause increased CNS or respiratory depression; dosage may need to be decreased.
• Erythromycin: Could potentially decrease the metabolism of butorphanol, prolonging its effects.
• Fentanyl (and other pure opiate agonists): Butorphanol may antagonize analgesic effects, but will also reverse sedative and respiratory depressant effects.
• Pancuronium: May cause increased conjunctival changes when used concurrently.
• Theophylline: Could potentially decrease the metabolism of butorphanol.
• Anaesthetic agents: Reduces the doses of other drugs required for induction and maintenance of anaesthesia
• Full mu-opioid agonists (e.g., methadone, fentanyl): Addition of butorphanol will reduce analgesia produced from the full mu agonist; combination is not recommended for analgesia
• Acepromazine: Synergistic sedation
• Alpha-2 agonists: Synergistic sedation and analgesia
• Full mu-agonist opioids (e.g., methadone, fentanyl): Butorphanol's mu-antagonist properties may block or partially reverse the analgesic effects of full mu-agonists. Higher doses of full mu-agonists may be required.

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