溴化鉀 / 溴化鈉

用途

• Refractory seizures (3rd choice therapy)
• Epilepsy (2nd line therapy)
• Seizures (Maintenance)
• Seizures (Rapid Loading Dose)
• Seizures (Alternative Loading Dose)
• Seizures (Alternative Loading Dose 2)
• Status epilepticus / NPO
• Seizures (IV Loading - Sodium Bromide)

給藥方式

可能的副作用

• Profound sedation (especially transiently during loading or when combined with phenobarbital)
• Polyphagia (increased appetite) and subsequent weight gain
• Polydipsia and polyuria (increased thirst and urination)
• Ataxia and hind limb paresis (signs of toxicity)
• Gastrointestinal upset (vomiting, anorexia, constipation)
• Pancreatitis (reported in combination with phenobarbital/primidone)
• Pruritic dermatitis (rare)
• Paradoxical hyperactivity (rare)
• Cats: Severe lower respiratory effects (cough, dyspnea, peribronchial infiltrates)

注意事項與禁忌

• Cats (relative to absolute contraindication due to severe pulmonary effects)
• Patients with severe renal dysfunction (requires extreme caution and dose adjustment)
• Pregnant or lactating animals (crosses placenta and enters milk, causing fetal growth retardation/intoxication)
• > **Dietary Warning:** Chloride intake must remain strictly consistent. Sudden increases in dietary salt (e.g., salty treats, switching to a high-chloride prescription diet) will cause rapid excretion of bromide and potential seizure breakthrough. * **Renal Impairment:** Use with caution in older animals or those with renal disease, as decreased GFR will lead to bromide accumulation and toxicity. * **Feline Patients:** Use with extreme caution, if at all, in cats due to the risk of fatal peribronchial infiltrates and dyspnea. * **GI Irritation:** Potassium bromide is a gastric irritant. Giving the medication with food or dividing the dose can help mitigate vomiting. If vomiting persists, switching to sodium bromide may be beneficial.

藥物相互作用

• CNS Sedating Drugs: Additive sedation and CNS depression.
• Diuretics (furosemide, thiazides): May enhance the renal excretion of bromides, lowering serum levels and potentially causing seizure breakthrough.
• High Chloride/Salt Diets: Increases renal excretion of bromide, reducing serum bromide levels and affecting seizure control.
• Low Chloride/Salt Diets: Decreases renal excretion of bromide, increasing serum bromide levels and risking bromide toxicity.
• Drugs that lower seizure threshold (e.g., xylazine): May potentially reduce the efficacy of antiseizure medications.

常見問題