Moxidectin toxicosis in a puppy successfully treated with intravenous lipids
Moxidectin toxicosis in a puppy successfully treated with intravenous lipids
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DOI：
10.1111/j.1476-4431.2009.00402.x
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发表时间：
2009-04-01
影响因子：
1.3
通讯作者：
Weinberg, Guy L.
中科院分区：
文献类型：
--
作者：
Crandell, Dawn E.;Weinberg, Guy L.
为了描述用静脉注射脂类药物的新疗法成功地治疗犬的莫西菌素中毒。一只16周大的雌性杰克-罗素梗犬出现急性癫痫发作，随后出现瘫痪和昏迷，怀疑接触了马匹配方的莫西菌素。后来证实了莫西菌素的毒性。最初的治疗包括安定、格列吡酯和静脉输液。根据需要给予机械通气和支持性护理。以20%豆油水乳剂作为肠外营养的脂肪成分，于暴露后10h开始静脉推注2m L/kg，4m L/kg/h，持续4h，于暴露后25.5h开始，以0.5m L/kg/m in的速度再次给药30min。第一次注射后有轻微改善，第二次注射后30分钟内显著改善。在第二次给药后6小时内，幼犬的神经功能恢复正常，没有复发。IV脂肪疗法是治疗莫西菌素中毒的一种新方法。它的使用得到了最近的研究和案例研究的支持，这些研究和案例研究涉及布比卡因和其他脂溶毒素的静脉给药。脂类给药似乎逆转了毒性的迹象，可能被证明是治疗莫西菌素和其他脂溶毒素的一种高效疗法。
To describe successful treatment of canine moxidectin toxicosis with the novel therapy of IV lipid administration.A 16-week-old female Jack Russell Terrier was presented with acute onset of seizures followed by paralysis and coma shortly following suspected exposure to an equine formulation of moxidectin. Moxidectin toxicity was later confirmed. Initial therapy consisted of diazepam, glycopyrrolate, and IV fluids. Mechanical ventilation and supportive nursing care were provided as needed. An emulsion of 20% soybean oil in water, commonly used as the fat component of parenteral nutrition, was administered intravenously as a bolus of 2 mL/kg followed by 4 mL/kg/h for 4 hours beginning 10 hours after exposure and was administered again at a rate of 0.5 mL/kg/min for 30 minutes beginning 25.5 hours post-exposure. Mild improvement was seen after the first dose, and dramatic improvement was noted within 30 minutes of the second dose. The puppy's neurologic status returned to normal within 6 hours of the second administration, with no relapses.IV lipid therapy is a novel treatment approach for moxidectin toxicity. Its use is supported by recent research and case studies involving IV lipid administration for bupivacaine and other fat-soluble toxins. Lipid administration appeared to reverse the signs of toxicity and may prove to be a highly effective therapy for moxidectin and other fat-soluble toxins.