Neurology and Neurosurgery Service, Centre for Small Animal Studies, Animal Health Trust, Newmarket, UK.
Centre for Preventive Medicine, Animal Health Trust, Newmarket, UK.
J Feline Med Surg. 2021 Feb;23(2):59-66. doi: 10.1177/1098612X20924925. Epub 2020 Jun 2.
The study objective was to investigate the prevalence and clinical characteristics of phenobarbitone-associated adverse effects in epileptic cats.
The medical records of two veterinary referral clinics from 2007 to 2017 were searched for cats fulfilling the inclusion criteria of a diagnosis of epilepsy, treatment with phenobarbitone and available follow-up information on the occurrence of adverse effects. Follow-up information was obtained from the medical records of the primary veterinarian and referral institutions and a questionnaire completed by the cats' owners.
Seventy-seven cats met the inclusion criteria. Fifty-eight were affected by idiopathic epilepsy and 19 by structural epilepsy. One or more of the following adverse effects were reported in 47% of the cats: sedation (89%); ataxia (53%); polyphagia (22%); polydipsia (6%); polyuria (6%); and anorexia (6%). Logistic regression analyses revealed significant associations between adverse effect occurrence and both phenobarbitone starting dosage and administration of a second antiepileptic drug (AED). For each 1 mg/kg q12h increment of phenobarbitone, the likelihood of adverse effects increased 3.1 times. When a second AED was used, the likelihood of adverse effects increased 3.2 times. No association was identified between epilepsy aetiology and adverse effect occurrence. An idiosyncratic adverse effect, characterised by severe neutropenia and granulocytic hypoplasia, was diagnosed in one cat. This resolved following phenobarbitone discontinuation.
The prevalence of phenobarbitone-associated adverse effects was 47%. Sedation and ataxia were most common. These are type A adverse effects and are predictable from phenobarbitone's known pharmacological properties. In the majority of cases, adverse effects occurred within the first month of treatment and were transient. Idiosyncratic (type B) adverse effects, which were not anticipated given the known properties of the drug, occurred in one cat. Increased phenobarbitone starting dosage and the addition of a second AED were significantly associated with the occurrence of adverse effects.
本研究旨在调查接受苯巴比妥治疗的癫痫猫中，药物相关不良反应的发生率和临床特征。
检索了 2007 年至 2017 年期间两家兽医转诊诊所的病历，纳入标准为：诊断为癫痫、接受苯巴比妥治疗、有不良反应发生的随访信息。随访信息来自主治兽医和转诊机构的病历，以及猫主人填写的问卷。
77 只猫符合纳入标准。其中 58 只为特发性癫痫，19 只为结构性癫痫。47%的猫出现了以下一种或多种不良反应：镇静（89%）；共济失调（53%）；多食（22%）；多饮（6%）；多尿（6%）；厌食（6%）。Logistic 回归分析显示，不良反应的发生与苯巴比妥起始剂量和使用第二种抗癫痫药物（AED）显著相关。苯巴比妥每增加 1mg/kg q12h，不良反应的发生几率增加 3.1 倍。使用第二种 AED 时，不良反应的发生几率增加 3.2 倍。癫痫病因与不良反应的发生无关。一只猫出现了一种特发性不良反应，表现为严重中性粒细胞减少和粒细胞减少症，停药后恢复正常。
苯巴比妥相关不良反应的发生率为 47%。最常见的不良反应是镇静和共济失调。这些是 A 类不良反应，可根据苯巴比妥的已知药理学特性预测。在大多数情况下，不良反应发生在治疗的第一个月内，且是一过性的。已知药物特性无法预测的特发性（B 类）不良反应仅发生在一只猫身上。增加苯巴比妥起始剂量和添加第二种 AED 与不良反应的发生显著相关。
