28. Sulfonylurea 類藥物因阻斷胰臟 β 細胞上何種離子通道而促進..-阿摩線上測驗

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28. Sulfonylurea 類藥物因阻斷胰臟 β 細胞上何種離子通道而促進其分泌胰島素？
(A) Na+
(B) K+
(C) Ca2+
(D) Cl−

二技統測◆藥學類◆(一)藥理學- 95 年 - 95-二技統測-藥學類-藥理學#13338

答案：B
難度： 適中

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大仁Jason藥師國三下 (2014/01/22)

藥物Glimepirid
(Amaryl)Glyburide
(Euglucon)Glipizide
(Minidiab)Gliclazide
(Diamicron MR)劑型劑量2mg/tab5mg/tab5mg/tab30mg/tab使用劑量1. Initial: 1 ~ 2 mg QD2. Maintenance:1~ 4 mg QD3. MAX 8 mg daily1. Initial: 2.5-5 mg QD2. Maintenance: 1.25-20 mg QD or in 2 divided doses3. MAX 20 mg/day1. Initial: 5 mg QD2. Maintenance: MAX 40 mg daily (if dose exceeds 15 mg, divide into at least 2 doses1. initial : 40~ 80 mg QD2. Maximum : 320 mg daily分類Sulfonylureas機轉1....
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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
T_1/2	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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28. Sulfonylurea 類藥物因阻斷胰臟 β 細胞上何種離子通道而促進..-阿摩線上測驗

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