글리부리드 (글리벤클라미드)

설포닐우레아계 항당뇨병제

글리부리드(글리벤클라미드라고도 함)는 **2세대 설포닐우레아계** 경구용 혈당 강하제입니다. 수의학에서는 주로 고양이의 **인슐린 비의존성 당뇨병(NIDDM)**에 대한 대체 경구 치료제로 사용됩니다. 주요 임상 포인트: * **글리피지드(Glipizide)의 대체제:** 글리피지드를 구할 수 없거나 보호자가 1일 1회 투여를 강력히 선호할 때 주로 고려됩니다. * **인슐린 치료가 우선:** 경구용 혈당 강하제를 시도해 볼 수 있지만, **인슐린 치료가 여전히 표준 치료(Gold Standard)**이며 고양이 당뇨병에 일반적으로 더 권장됩니다. * **효능:** 심각한 인슐린 저항성을 보이거나 췌장 베타 세포 기능이 고갈된 고양이에게는 글리부리드가 효과적이지 않을 수 있습니다.

작용 기전: Glyburide lowers blood glucose concentrations by stimulating the secretion of endogenous insulin from functional pancreatic beta cells. **Mechanism of Action:** * Binds to **sulfonylurea receptor 1 (SUR1)** subunits on **ATP-sensitive potassium channels (K-ATP)** in the pancreatic beta-cell membrane. * **K-ATP channel closure** → cell membrane depolarization. * Depolarization triggers the opening of **voltage-dependent calcium channels** → **Calcium influx**. * Increased intracellular calcium promotes the exocytosis of **insulin** granules. **Extrapancreatic Effects:** With long-term administration, glyburide may also enhance insulin activity at post-receptor sites and reduce basal hepatic glucose production.

동물 종별 용량

Cats

Non-insulin dependent diabetes mellitus (NIDDM) · 0.625 mg (1/2 of a 1.25 mg tablet) · PO · once daily · Initial dose
Non-insulin dependent diabetes mellitus (NIDDM) · 2.5 mg (total dose) · PO · twice a day · If cat is generally well, weight loss is mild, is not ketoacidotic, and does not have peripheral neuropathy

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

금기

Severe burns
Severe trauma
Severe infection
Diabetic coma or other hypoglycemic conditions
Major surgery
Ketosis
Ketoacidosis or other significant acidotic conditions

이상반응

Vomiting
Hypoglycemia
Liver toxicity (icterus, increased ALT/SGPT)
Allergic skin reactions (reported in humans)
Arthralgia (reported in humans)
Bone marrow suppression (reported in humans)
Cholestatic jaundice (reported in humans)

약물 상호작용

Alcohol · A disulfiram-like reaction (anorexia, nausea, vomiting) is possible
Azole Antifungals (ketoconazole, itraconazole, fluconazole) · May increase plasma levels of glyburide
Beta-blockers · May potentiate hypoglycemic effect
Chloramphenicol · May displace glyburide from plasma proteins
Cimetidine · May potentiate hypoglycemic effect
Corticosteroids · May reduce efficacy
Thiazide Diuretics · May reduce hypoglycemic efficacy
Isoniazid · May reduce hypoglycemic efficacy
MAO Inhibitors · May potentiate hypoglycemic effect
Niacin · May reduce hypoglycemic efficacy
Phenothiazines · May reduce hypoglycemic efficacy
Phenytoin · May reduce hypoglycemic efficacy
Probenecid · May potentiate hypoglycemic effect
Sulfonamides · May displace glyburide from plasma proteins

모니터링

Physical examination (weekly during first month)
Body weight (weekly during first month)
Urine glucose and ketones (weekly during first month)
Serial blood glucose exams (weekly during first month)
Clinical signs of adverse effects (vomiting, icterus)
Liver enzymes (ALT/SGPT) occasionally
Complete Blood Count (CBC) occasionally

과용량

> **Emergency Warning:** Profound **hypoglycemia** is the greatest concern after an overdose. * In humans, severe hypoglycemia has occurred at relatively low dosages. * **Decontamination:** Gut emptying protocols should be employed when warranted and if the patient is neurologically stable. * **Treatment:** Because its half-life is longer than glipizide, prolonged hypoglycemia may occur. Continuous blood glucose monitoring and treatment with parenteral glucose (IV dextrose) may be required for several days. * **Monitoring:** Massive overdoses may also require additional monitoring (blood gases, serum electrolytes) and supportive therapy.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.