agen hioglisemik oral

8/7/2019 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.

agen hioglisemik oral

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