Sulfonylureas and its Description

Type of Drug:

Oral antidiabetic agents for use only as an adjunct to diet and exercise in the management of type 2 (non-insulin-dependent) diabetes mellitus.

How the Sulfonylureas Works:

The sulfonylurea hypoglycemic agents appear to decrease blood sugar by stimulating the release of insulin from the pancreas. Sulfonylureas may also decrease the amount of sugar that is dumped into the blood from the liver and may increase the sensitivity of fat and muscle tissue to the action of insulin. By increasing the amount of insulin or The effectiveness of insulin, blood sugar levels are lowered. Sulfonylureas do not work in type 1 (insulin-dependent) diabetes mellitus in which the pancreas is not capable of manufacturing or releasing insulin.

Uses of Sulfonylureas:

As an adjunct to diet and exercise to low or blood glucose In patients with type 2 diabetes mellitus whoso hyperglycemia cnn not bo controlled by diet and exercise alone. They may be used or combined with other blood sugar lowering medicine (eg. thiazolidinediones,metformin,insulin).

Precatuions:

Alcohol: A reaction may occur, including facial flushing, changes in blood sugar, and breathlessness, when alcohol is ingested. This occurs most often in patients taking.

Diet and exercise: Diet and exercise are the primary management of type 2 diabetes. Sulfonylureas are used with, not as a substitute for, diet and exercise.

Hyperglycemia (high blood sugar levels): Hyperglycemia is a major risk factor in the development of diabetes complications. Maintaining blood sugar levels as close to normal as possible is important. Symptoms of hyperglycemia include excessive thirst or urination, nausea, and stomach upset.

Hypoglycemia (low blood sugar levels): Patients with kidney or liver problems or patients taking more than blood glucose lowering medicine may be at higher risk for the development of medication-induced hypoglycemia. Symptoms include shaking, dizziness, faintness, headache, irritability, confusion, fatigue, excessive hunger, profuse sweating, numbness of arms or legs, and rapid pulse. May lead to convulsions or coma if extremely severe.

To prevent hypoglycemia:

  • Understand the symptoms of low blood sugar levels.
  • Maintain an adequate diet. Do not miss meals.
  • Frequently monitor blood glucose levels.
  • Keep a source of quick-acting sugar with you at all times.
  • Know how exercise, alcohol, and other drugs affect your blood sugar level.

Hypoglycemia is more of a problem with chlorpropamide than with their medications in this class. Discuss the expected results of your sulfonyluroa therapy with your doctor, pharmacist, or diabetes educator. Know the onset of action, peak activity, and total duration of activity.

Heart disease: long term use of sulfonyureas has been associate with increased risk of development of heart problem compared with diet along or diet plus insulin.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed. In general, avoid sulfonylureas in pregnancy. They will not provide good control in patients whose blood glucose levels cannot be controlled by diet alone. Insulin is recommended to treat pregnant patients with diabetes to maintain blood glucose levels as close to normal as possible.

Breastfeeding: Chlorpropamide is excreted in breast milk. It is not known if other sulfonylureas appear in breast milk. Because of the potential for hypoglycemia in nursing infants, decide whether to discontinue nursing or discontinue the drug. Consult your doctor before you begin breast feeding.

Children: Safety and effectiveness in children have not been established. Elderly: Elderly, debilitated, or malnourished patients may be particularly sensitive to sulfonylureas. If there is a tendency toward hypoglycemia (low blood sugar levels), dosage will be reduced or therapy discontinued by your doctor. Use with caution.

Lab Tests: Lab tests will be required to monitor therapy. Tests may include blood glucose, glycosylated hemoglobin, and kidney and liver function tests.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements while taking sulfonamides. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with sulfonylureas:

Other: Digitalis glycosides (eg, dioxin); ciprofloxacin (eg, Cipro); ethanol; barbiturates (eg, phenobarbital).

Side Effects:

Every drug is capable of producing side effects. Many sulfonylurea users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; heartburn; feeling of fullness; diarrhea; vomiting; appetite loss; taste alteration (tolbutamide only); gas; constipation; stomach pain; indigestion; hunger.

Narvous System: Weakness; dizziness; headache; abnormal skin sensations; drowsiness; nervousness; tremor; sleeplessness; anxiety; depression; decreased sensitivity to stimulation; confusion.

Skin: Yellowing of the skin or eyes; rash; hives; dry, red skin; itching; sensitivity to sunlight; sweating.

Other: Abnormal blood counts and blood tests; pain; dark urine; leg cramps; fainting;join or muscle pain ;runny nose ;blurred;vision;excessive urination ;low blood sugar.

Guidelines for Use:

  • Dosage is individualized. Do not change dose or stop taking this medicine unless advised to do so by your doctor.
  • Follow the diet and exercise program and personal hygiene and infection avoidance regimens exactly as prescribed by your doctor.
  • May be taken with food if stomach upset Occurs. Always take immediate¬≠release glipizide 30 minutes prior to a meal to increase effectiveness.
  • Avoid alcohol. It can cause flushing, breathlessness, and changes in blood sugar.
  • Avoid aspirin in large doses.
  • Get specific instructions from your doctor on how to examine your feet for complications of diabetes. In addition, obtain equipment for and learn the correct process of home glucose monitoring. Monitor blood sugar levels as recommended by your doctor. Notify your doctor if you experience low blood sugar symptoms (eg, fatigue, excessive hunger, profuse sweating, numbness of arms or legs, rapid pulse, confusion) or high blood sugar symptoms (eg, bad breath, excessive thirst or urination).
  • Diet and exercise are the primary managements of type 2 diabetes. these medications should be used with, not as a substitute for, diet and exercise.
  • To prevent hypoglycemia – Understand the symptoms of low blood sugar levels. Maintain an adequate diet. Do not miss meals. Know how exercise, alcohol, and other drugs affect blood sugar levels. During periods of stress such as fever, trauma, infection, or surgery, modication requirements may change. Consult your doctor.
  • Long-term use of sulfonylureas may be associated with increased heart when compared with diet treatment alone, or diet plus insulin. Patients with heart problems or concern bout heart problems should should their doctor.
  • Glipizide, extended-release – Do not crush, chew, or divide tablets. DO not be alarmed if the tablet shell appears in the stool. This drug is loosened to slowly release the medicine and then expel the empty shell the body.
  • MaY cause sensitivity to sunlight. Avoid prolonged exposure to the sun. Use sunscreens and wear protective clothing until tolerance is `
  • May cause drowsiness or dizziness. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
  • Lab tests will be required to monitor therapy. Be sure to keep appointments.
  • Store at controlled room temperature. Protect from moisture.



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