◾藥物類型
一、口服降血糖藥
1.磺醯尿素類:刺激胰臟分泌較多量的胰島素。如Euglucon(優爾康)、Glidiab(泌樂得)、Diabinese(特泌胰)、Diamicron(岱密克龍)。
2.雙胍類:抑制肝臟製造葡萄糖並促進萄葡糖的利用。如 Melbin(美治寧)、Glucophage(庫魯化)。
3.阿爾發葡萄糖甘脢抑制劑:抑制多醣類分解。如Acarbose (醣祿)。
4.Thiazolidinedione:增加胰島素敏感性及反應度。
5.GuaRina 減少腸胃道吸收葡萄糖
二、注射胰島素 適應症
1.第一型糖尿病患者。
2.糖尿病酮酸血症。
3.高血糖高滲透壓非酮酸性昏迷。
4.糖尿病孕婦。
5.飲食控制及口服降血糖藥無效者。
6.對口服藥有不良反應或過敏現象者。
7.有明顯的肝、腎功能障礙者。
8.重大手術的病人。
9.處於重大壓力下,如頭部外傷、心肌梗塞。
◾藥物副作用~低血糖
一、低血糖的症狀
臉色蒼白、盜汗、頭暈、頭痛、手腳發抖、飢餓感、心跳加快
二、低血糖的定義
血糖值在70 mg/dl以下〈症狀可能50 mg/dl以下才會出現〉或是血糖由高濃度急速下降,雖然血糖仍然偏高,亦可能產生低血糖症狀。
三、低血糖的原因
1.未進食或吃的太少或太晚進食
2.口服降血糖劑量太多或胰島素注射過量
3.過度運動
四、低血糖的處理
1.當病人意識清醒時:服用方糖2~3塊或半杯橘子汁、可樂、汽水或二茶匙糖,症狀輕者約5~10分改善,15分後未改善則可重複再給一次,如仍未改善,則應馬上送醫。
2.如果意識不清時:肌肉或皮下注射昇糖素,假使沒有昇糖素者,請勿給任何東西,以防嗆到,需立刻送醫急救。
五、低血糖的預防
1.按時且定量進食三餐和點心
2.勿空腹去運動 若有額外的運動,需先進食點心
3.胰島素注射劑量需正確,注射後15~30分應進食
4.隨時攜帶葡萄糖,以備低血糖發作時服用
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