米托坦
別名: Lysodren
- **隨餐服用：** 請務必在寵物進食後（最好是含有一些脂肪或油脂的食物）立即給予此藥物，以確保良好的吸收。 - **注意副作用：** 此藥物的目的是降低皮質醇濃度，但有時可能會降得太低。請密切觀察您的寵物是否有「艾迪生氏危機」的跡象，包括**嗜睡、虛弱、嘔吐、腹瀉或突然食慾不振**。 - **生病時停藥：** 如果您的寵物停止進食或出現上述任何症狀，**請立即停止給藥**並聯絡您的獸醫師。獸醫師可能會指示您給予急救劑量的類固醇（如潑尼松）。 - **安全預防措施：** 米托坦是一種強效的細胞毒性藥物。處理藥片時請戴上手套，或在給藥後徹底洗手。請將藥物嚴格存放在兒童和其他寵物接觸不到的地方。 - **壓力時期：** 在壓力時期（如手術、寄宿或急性疾病），您的寵物可能需要額外的類固醇藥物。請與您的獸醫師討論此情況。
劑量必須由獸醫依你寵物的個別情況決定。切勿在沒有獸醫指導下給予人類藥物或其他寵物的處方藥。
用途
- Hyperadrenocorticism
- Medical treatment of hyperadrenocorticism
- Pituitary-dependent hyperadrenocorticism (Induction - Protocol A)
- Pituitary-dependent hyperadrenocorticism (Maintenance - Protocol A)
- Pituitary-dependent hyperadrenocorticism (Induction - Protocol B)
- Pituitary-dependent hyperadrenocorticism (Maintenance - Protocol B)
- Pituitary-dependent hyperadrenocorticism (Induction - Protocol C)
- Pituitary-dependent hyperadrenocorticism (Maintenance - Protocol C)
- Total adrenal ablation (Alternative Protocol D)
- Total adrenal ablation (Alternative Protocol E)
- Palliative medical treatment of adrenal carcinomas or adenomas
- Pituitary-dependent hyperadrenocorticism (Induction)
給藥方式
可能的副作用
- Lethargy
- Ataxia
- Weakness
- Anorexia (loss of appetite)
- Vomiting
- Diarrhea
- Neurologic signs (uncommon)
- Liver changes (congestion, centrolobular atrophy, fatty degeneration)
- Iatrogenic hypoadrenocorticism (requiring long-term glucocorticoid/mineralocorticoid replacement in ~5% of dogs)
- Anorexia
- Diarrhoea
- Acute-onset neurological signs (2-3 weeks post-initiation)
- Iatrogenic hypoadrenocorticism
注意事項與禁忌
- Known hypersensitivity to mitotane
- Pregnancy (FDA Category C in humans; Class D in veterinary medicine - embryotoxic/teratogenic)
- Patients that are not eating well (should never be administered to anorexic animals)
- Not recommended in cats (trilostane is more effective and mitotane efficacy is highly variable)
- > **Warning:** Mitotane should never be administered to animals that are not eating well. * **Diabetes Mellitus:** Concurrent diabetes requires close monitoring as insulin requirements may rapidly decrease during initial treatment. * **Organ Dysfunction:** Dogs with preexisting renal or hepatic disease should receive the drug with extreme caution and intense monitoring. * **Stress Supplementation:** All dogs receiving mitotane therapy must receive additional glucocorticoid supplementation if undergoing physiological stress (e.g., surgery, trauma, acute illness). * **Human Safety:** Mitotane is a cytotoxic drug. Caregivers should avoid direct skin contact (wear gloves) and wash hands after administration.
藥物相互作用
- CNS Depressants: Additive depressant effects may be seen if used concomitantly.
- Insulin: Diabetic dogs receiving insulin may have their insulin requirements rapidly decreased when mitotane therapy is instituted.
- Phenobarbital: Can induce enzymes and reduce the efficacy of mitotane; conversely, mitotane can induce hepatic microsomal enzymes and increase the metabolism of phenobarbital.
- Spironolactone: Has been demonstrated to block the action of mitotane in dogs; an alternate diuretic is recommended.
- Barbiturates: Increases the hepatic metabolism of mitotane
- Corticosteroids: Increases the hepatic metabolism of mitotane
常見問題
米托坦用於寵物有什麼用途？
- **隨餐服用：** 請務必在寵物進食後（最好是含有一些脂肪或油脂的食物）立即給予此藥物，以確保良好的吸收。 - **注意副作用：** 此藥物的目的是降低皮質醇濃度，但有時可能會降得太低。請密切觀察您的寵物是否有「艾迪生氏危機」的跡象，包括**嗜睡、虛弱、嘔吐、腹瀉或突然食慾不振**。 - **生病時停藥：** 如果您的寵物停止進食或出現上述任何症狀，**請立即停止給藥**並聯絡您的獸醫師。獸醫師可能會指示您給予急救劑量的類固醇（如潑尼松）。 - **安全預防措施：** 米托坦是一種強效的細胞毒性藥物。處理藥片時請戴上手套，或在給藥後徹底洗手。請將藥物嚴格存放在兒童和其他寵物接觸不到的地方。 - **壓力時期：** 在壓力時期（如手術、寄宿或急性疾病），您的寵物可能需要額外的類固醇藥物。請與您的獸醫師討論此情況。
米托坦對我的寵物安全嗎？
劑量必須由獸醫依你寵物的個別情況決定。切勿在沒有獸醫指導下給予人類藥物或其他寵物的處方藥。
本文僅供一般健康教育，不能取代專業獸醫意見。如寵物身體不適，請諮詢獸醫。