グリメピリド
経口、1日1回投与の抗血糖薬。猫のインスリン非依存性糖尿病（NIDDM）の補助治療に有用な可能性があります。猫での使用経験は非常に限られています。
作用機序: Glimepiride is a medium- to long-acting **secretagogue sulfonylurea**. **Primary Mechanism:** - Binds to the **SUR1 receptor** on the membrane of functioning pancreatic beta cells. - Closes ATP-sensitive potassium (K+) channels → cell depolarization. - Opens voltage-gated calcium (Ca2+) channels → calcium influx. - Triggers the exocytosis and **release of insulin** granules into the bloodstream. **Secondary Mechanism:** - With continued use, it may also increase peripheral tissue sensitivity to insulin, reducing insulin resistance.
動物種別の用量
- Treatment of NIDDM · 2 mg (total dose) per cat · PO · once daily
- Treatment of NIDDM · 1-2 mg (total dose per cat) · PO · once daily
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Hypersensitivity to glimepiride or other sulfonylureas
- Diabetic ketoacidosis (DKA)
有害事象
- Hypoglycemia
- Dizziness
- Asthenia
- Liver function impairment (rare)
- Allergic respiratory reactions (rare)
- Dermatologic reactions (rare)
- Hematologic reactions (rare)
薬物相互作用
- Azole Antifungals (ketoconazole, itraconazole, fluconazole) · May increase plasma levels of glimepiride
- Beta-Blockers · May potentiate hypoglycemic effect
- Chloramphenicol · May displace glimepiride from plasma proteins
- Corticosteroids · May reduce efficacy
- Thiazide Diuretics · May reduce hypoglycemic efficacy
- Isoniazid · May reduce hypoglycemic efficacy
- Niacin · May reduce hypoglycemic efficacy
- Phenothiazines · May reduce hypoglycemic efficacy
- Phenytoin · May reduce hypoglycemic efficacy
- Sulfonamides · May displace glimepiride from plasma proteins
- Sympathomimetic Agents · May reduce hypoglycemic efficacy
- Warfarin · May displace glimepiride from plasma proteins
モニタリング
- Fasting blood glucose
- Appetite and attitude
- Body condition
- PU/PD resolution
- Serum fructosamine
- Glycosylated hemoglobin levels
- Signs of hypoglycemia
過量投与
Overdoses can lead to **hypoglycemia**, ranging from mild to severe and life-threatening. **Treatment:** - Immediate **glucose administration** (oral if conscious, IV dextrose if severe/unconscious). - **Intensive monitoring** is critical. - Due to the drug's long duration of activity, patients may require continuous glucose support (e.g., IV dextrose CRI) for **at least 48 hours** post-ingestion, even after apparent clinical recovery.
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。