Читать книгу Canine and Feline Epilepsy - Luisa De Risio - Страница 227

There is no specific antidote for amphetamines or amphetamine-like drug intoxication. Treatment involves decontamination (induction of emesis in asymptomatic animals or gastric lavage followed by the administration of activated charcoal and a cathartic) (Table 4.1), supportive care (including fluid therapy and convective whole body cooling), methocarbamol in animals with tremors and AEMs in seizuring animals (see Table 4.1 and Chapters 12 and 24). Diazepam administration has been reported to increase excitability in some dogs with amphetamine toxicosis and it is therefore avoided to control hyperactivity, restlessness, irritability or other excitatory behavioural changes; however, it can be used in the acute management of seizures (Albretsen, 2002; Stern and Schell, 2012). Phenothiazine tranquilizers have been recommended to control hyperactivity, restlessness, irritability or other behavioural changes (Stern and Schell, 2012). Acepromazine can initially be administered at 0.05 mg/kg IV and titrated to effect. The dose can be gradually increased to 0.1 to 1.0 mg/kg if clinical signs do not resolve with lower doses. Alternatively, chlorpromazine can initially be administered at 0.5 mg/kg IV and subsequently titrated up to effect. Blood pressure should be monitored at higher doses of phenothiazine to ensure that hypotension does not occur. Animals should be kept in a dark and quiet area and stimulation should be minimized (Stern and Schell, 2012). Treatment of tachycardia or other cardiac arrhythmias may sometimes be required. Urinary acidification has been recommended (to a pH of between 4.5 and 5.5) to enhance the elimination of amphetamines. This can be achieved with ammonium chloride administration at 100 to 200 mg/kg/day PO divided four times daily or ascorbic acid 20–30 mg/kg PO, SQ, IM or IV. Urinary acidification should not be attempted if the animal is acidotic, if acid-base status cannot be monitored regularly, or in case of rhabdomyolosis or acute renal failure (Albretsen, 2002; Stern and Schell, 2012).