格列美脲
口服、每日一次的降血糖藥物；可作為貓非胰島素依賴型糖尿病 (NIDDM) 的輔助治療。在貓的臨床經驗非常有限。
作用機制: 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.
各物種劑量
- 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
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
禁忌症
- Hypersensitivity to glimepiride or other sulfonylureas
- Diabetic ketoacidosis (DKA)
不良反應
- Hypoglycemia
- Dizziness
- Asthenia
- Liver function impairment (rare)
- Allergic respiratory reactions (rare)
- Dermatologic reactions (rare)
- Hematologic reactions (rare)
藥物相互作用
- 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
監測
- Fasting blood glucose
- Appetite and attitude
- Body condition
- PU/PD resolution
- Serum fructosamine
- Glycosylated hemoglobin levels
- Signs of hypoglycemia
過量
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 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。