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[犬猫癫痫治疗中的药理学原理]

[Pharmacologic principles in the treatment of epilepsy in the dog and cat].

作者信息

Frey H H, Schwartz-Porsche D

出版信息

Tierarztl Prax. 1985;13(4):541-9.

PMID:3834646
Abstract

The pharmacokinetics of antiepileptic drugs used for the treatment of human epilepsies is reviewed for dogs and cats. In dogs, especially phenobarbital and primidone must be regarded as useful drugs for chronic treatment on account of their elimination rate and bioavailability. Phenytoin, carbamazepine, valproic acid and benzodiazepines are eliminated so rapidly that a therapeutic value cannot be expected. In cats, phenytoin, phenobarbital, valproic acid and diazepam must be regarded as suited for chronic treatment, but there is a definite lack of clinical experience. Phenobarbital and primidone are useful for treatment of clonic-tonic generalized seizures (grand mal) in dogs. The effect of primidone depends mostly on its metabolite phenobarbital. Since primidone, given in high dosage for longer periods of time, gives rise to liver damage, phenobarbital is regarded as the drug of first choice. A status epilepticus may be treated by i.v. injection of diazepam, clonazepam, phenytoin or lidocaine. In cats with grand mal, treatment with daily doses of about 1 mg/kg diazepam may be tried. It proved effective for longer time periods without development of tolerance. There is no reliable clinical experience with other drugs in this species.

摘要

本文综述了用于治疗人类癫痫的抗癫痫药物在犬猫体内的药代动力学。在犬类中,尤其是苯巴比妥和扑米酮,鉴于其消除率和生物利用度,必须被视为慢性治疗的有效药物。苯妥英、卡马西平、丙戊酸和苯二氮䓬类药物消除速度极快,因此无法预期其治疗价值。在猫类中,苯妥英、苯巴比妥、丙戊酸和地西泮被认为适合慢性治疗,但明显缺乏临床经验。苯巴比妥和扑米酮对犬类的阵挛 - 强直全身性癫痫发作(大发作)治疗有效。扑米酮的作用主要取决于其代谢产物苯巴比妥。由于长期高剂量使用扑米酮会导致肝损伤,因此苯巴比妥被视为首选药物。癫痫持续状态可通过静脉注射地西泮、氯硝西泮、苯妥英或利多卡因进行治疗。对于患有大发作的猫,可尝试每日按约1mg/kg的剂量使用地西泮进行治疗。事实证明,该方法在较长时间内有效且不会产生耐受性。对于该物种使用其他药物,尚无可靠的临床经验。

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