保泰松、非甾体类抗炎药(昔布类)和安乃近对马呋塞米利尿反应的影响。

Effects of phenylbutazone, firocoxib, and dipyrone on the diuretic response to furosemide in horses.

机构信息

Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.

出版信息

J Vet Intern Med. 2023 Nov-Dec;37(6):2544-2551. doi: 10.1111/jvim.16914. Epub 2023 Oct 26.

Abstract

BACKGROUND

Treatment with phenylbutazone (nonselective COX inhibitor) decreases the diuretic and natriuretic effects of furosemide by nearly 30% but the effects of COX-2 specific inhibitors (firocoxib) and atypical NSAIDs (dipyrone) are unknown.

HYPOTHESIS

Furosemide-induced diuresis after pretreatment with firocoxib or dipyrone is diminished to a lesser extent than after pretreatment with phenylbutazone.

ANIMALS

Eight healthy mares.

METHODS

Each mare received 4 treatments in a prospective experimental crossover study using a replicated 4 × 4 Latin Square design: furosemide alone (FU), furosemide and phenylbutazone (PB), furosemide and firocoxib (FX), and furosemide and dipyrone (DP). After 24 hours of NSAID treatment at recommended dosages, ureteral catheters were placed for continual urine collection. After a 30-minute baseline collection period, furosemide (1.0 mg/kg, IV) was administered, and urine and blood samples were collected for 4 hours. Data were assessed by repeated measures ANOVA.

RESULTS

Four-hour urine volume was (mean ± SD) ~25% less (P < .001) after pretreatment with all NSAIDs (PB 19.1 ± 2.1 mL/kg, FX 17.7 ± 3.5 mL/kg, DP 19.1 ± 3.9 mL/kg), as compared to FU (23.4 ± 5.1 mL/kg) (P < .001), but there were no differences between PB, FX, or DP. Interindividual variability in furosemide diuresis after pretreatment with different NSAIDs was observed.

CONCLUSIONS AND CLINICAL IMPORTANCE

Though COX-2 selective NSAIDs and dipyrone might have less severe or fever gastrointestinal adverse effects in horses, our data suggest minimal differences in effects on furosemide-induced diuresis, and possibly, risk of nephrotoxicosis.

摘要

背景

使用苯丁唑酮(非选择性 COX 抑制剂)治疗可使呋塞米的利尿和排钠作用降低近 30%,但 COX-2 特异性抑制剂(非诺昔康)和非典型 NSAIDs(安乃近)的作用尚不清楚。

假设

与苯丁唑酮预处理相比,非诺昔康或安乃近预处理后,呋塞米诱导的利尿作用降低的程度较小。

动物

8 匹健康母马。

方法

在一项前瞻性实验交叉研究中,每匹马接受 4 种治疗,采用重复的 4×4 拉丁方设计:呋塞米单独(FU)、呋塞米和苯丁唑酮(PB)、呋塞米和非诺昔康(FX)、呋塞米和安乃近(DP)。在 NSAID 按推荐剂量治疗 24 小时后,放置输尿管导管进行连续尿液收集。在 30 分钟基线采集期后,静脉注射呋塞米(1.0mg/kg),并在 4 小时内采集尿液和血液样本。数据通过重复测量方差分析进行评估。

结果

与 FU(23.4±5.1mL/kg)相比,所有 NSAIDs(PB 19.1±2.1mL/kg、FX 17.7±3.5mL/kg、DP 19.1±3.9mL/kg)预处理后 4 小时尿量减少约 25%(P<0.001),但 PB、FX 或 DP 之间无差异。在不同 NSAIDs 预处理后,呋塞米利尿作用的个体间差异较大。

结论和临床意义

虽然 COX-2 选择性 NSAIDs 和安乃近在马中可能具有较轻或发热的胃肠道不良反应,但我们的数据表明,它们对呋塞米诱导的利尿作用的影响差异极小,可能对肾毒性的风险也极小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4081/10658499/310dade5c863/JVIM-37-2544-g002.jpg

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