婉婷提供的
|
藥物
|
Glimepirid
(Amaryl) |
Glyburide
(Euglucon) |
Glipizide
(Minidiab) |
Gliclazide
(Diamicron MR) |
|
劑型劑量
|
2mg/tab
|
5mg/tab
|
5mg/tab
|
30mg/tab
|
|
使用劑量
|
1. Initial: 1 ~ 2 mg QD
2. Maintenance:1~ 4 mg QD
3. MAX 8 mg daily
|
1. Initial: 2.5-5 mg QD
2. Maintenance: 1.25-20 mg QD or in 2 divided doses
3. MAX 20 mg/day
|
1. Initial: 5 mg QD
2. Maintenance: MAX 40 mg daily (if dose exceeds 15 mg, divide into at least 2 doses
|
1. initial : 40~ 80 mg QD
2. Maximum : 320 mg daily
|
|
分類
|
Sulfonylureas
|
|||
|
機轉
|
1. 阻斷β-cell的ATP依賴性K+ 通道，使β-cell去極化，產生脫顆粒作用，釋放胰島素 (major)
2. 降低肝臟製造葡萄糖的能力
3. 加強周邊對胰島素的敏感性
4. 必須在胰臟仍有分泌胰島素功能時才有作用
5. 使用時需監測血糖值及HbA1c
|
|||
|
Onset
|
2~4 hr
|
30 min
|
30 min
|
4 ~ 5 hr
|
|
Duration
|
24 hr
|
16~24 hr
|
10~24 hr
|
24 hr
|
|
T1/2
|
9 hr
|
5~10 hr
|
2~5 hr
|
8 ~12 hr
|
|
Excretion
|
Fecal: 40%
Renal: 60%
|
Renal and biliary= 50%:50%
|
Renal: 63~89%
feces: 20% |
Renal: 60% to 80%
Feces, 20%
|
|
Contraindications
|
1. diabetic ketoacidosis
2. pregnancy complicated by diabetes mellitus
|
diabetic ketoacidosis
|
||
|
Precautions
|
1. susceptible to hypoglycemia:
ü elderly, debilitated, or malnourished patients
ü hepatic insufficiency
ü stress caused by infection, fever, trauma, or surgery
2. lactation
|
1. susceptible to hypoglycemia :
ü elderly, debilitated, or malnourished patients
ü adrenal or pituitary insufficiency
ü hepatic or renal insufficiency
ü stress caused by infection, fever, trauma, or surgery
2. pregnancy or lactation
|
1. Hypoglycemia
2. Liver disease
3. Periods of stress (eg, infection, fever, trauma, surgery) (insulin may be needed)
4. Renal insufficiency, moderate-to-severe
|
|
|
Note
|
AC
|
1. titrate dose slowly if used concurrently with metformin
2. AC or PC
|
give 30 min before a meal
|
AC or PC
|
|
測血糖時間
|
監測血糖時間點：一天二次，空腹時monitor
|
|||
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