Agen hioglisemik oral
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Transcript of Agen hioglisemik oral
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Definisi
- Ubat yang digunakan untuk
merawat DM
(Non Insulin Dependent DiabetesMellitus ,NIDDM).
- untuk menurunkan paras gula yangtinggi di dalam darah
(hiperglisemia)
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Indikasi
- NIDDM
-Diklasifikasikan kepada dua Kumpulan Ubat:
i. Sulfonylureas
ii. Non-sulfonylureas / Dimethylbiguanide
(Biguanide)
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i. SULFONYLUREAS
a. Short acting
- Tolbutamide
b.Medium acting
- Tolazamide- Acetohexamide
- Glipizide
- Glyburide
c. Long acting
- Chlorpropamide
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ii. BIGUANIDE
-Metformin (Glucophage)
-Phenformin
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i. SULFONYLUREAS
- Digunakan apabila pengeluaran insulin tidakmencukupi oleh pankreas (pankreas masih
berfungsi)
Tindakan
-merangsang sel-sel beta pankreas untuk
merembesinsulin.
- memperkuatkan tindakan insulin di tisu-tisu
(periferi).
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i. SULFONYLUREAS
Tindakan
Sulfonylurea
Sel-sel beta
(Pankreas)
Mensintesis
& merembes
insulin
Menurunkan
paras gula
Merangsang
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1.GLIBENCLAMIDE (Daonil)
-Indikasi:
Type 2 DM (NIDDM)
-Kaedah pemberian: oral
-Dos: 2.5- 5mg (after food) .
Dos maksimum: 15mg/hari.
-S/E: hipersensitiviti
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2. TOLBUTAMIDE (Rastinon)
ubat jangka pendek
Indikasi
- NIDDM
-Tak terkawal dgn bersenam dan diet
Dos
- P.Oral: 250 mg 3gm (1 or 2 divided
doses
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Kontraindikasi
- Hipersensitiviti (Sulfonylureas / Sulphonamide)
- Sejarah Diabetic Ketoacidosis
berulang- Diabetic Coma
- IDDM
Kesan sampingan- anaemia aplastik
- reaksi allergi
- hipoglisemia (Overdose)- mual / muntah
Interaksi ubat
-Thiazide (Diuretik) menerukkan hipoglisemia
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3. GLIPIZIDE
Jangka sederhana
Indikasi
- NIDDM
- Tambahan kepada pengawalan melalui diet &
bersenam
Dos
- P.O. 2.5mg 5mg , 30 min sebelum makan
- dos maksimum: 40 mg /hari
Onset - 15 30 min
Kemuncak tindakan 1 2 jam
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Kontraindikasi
- Diabetic Ketoacidosis
Kesan sampingan
- Anemia aplastik- Urticaria
-Gangguan gastrousus
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4. CHLOPROPAMIDE (Diabenese)
Jangka panjang
Indikasi
-NIDDM
jika diet & bersenam tidak berjaya
Dos
- Oral: 250 -500mg ( 30 minit sebelum makan)
S/E:
-mual -muntah
-sakit kepala -sakit epigastrium
-gatal-gatal
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ii. BIGUANIDE
- Ubat agen hipoglisemik (bukan kumpulan
sulfonylureas
Tindakan ubat
- Menggalak pengangkutan glukosamenyeberangi
dinding sel.
- Menambah pengambilan glukosa di tisu-tisu
pinggiran
- Mengurangkan glukoneogenesis di hepar.
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Contoh ubat Biguanide
1. Metformin (Glucophage)
Indikasi
- Diabetis Mellitus
Kaedah Pemberian
- Oral
Dos: 500mg daily / BD
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Kesan sampingan
- gangguan gastrousus- loya
- muntah
- Cirit birit
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Advice on Medication 1. Once the drugs are taken, do not delay themealtime.
2. If you miss a dose, take it as soon aspossible unless it is almost time for the nextscheduled dose. In that case, skip the misseddose and take the next dose as directed. Donot take double doses.
3. In case of frequent symptoms of lowblood sugar such as hunger, weakness,trembling, cold sweating and dizziness,inform your doctor.
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4. If the patient becomes unconsciousness orgoes into coma, he/she should be rushed to
the accident and emergency department byhis/her family members.
5.As soon as symptoms of low blood sugar
occur, the patient should immediately takesome sugary food and drinks such as juice,
honey and glucose.
5. If you are taking other drugs as well,
inform your doctor to avoid medicinal
interference which affects drug efficacy.