Sulfonylureas (Old)
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Summary
Sulfonylureas are a drug class including the drugs glimepiride, glyburide, and glipizide. These drugs are used to lower blood sugar, to treat people with type 2 diabetes. An important risk to note is the potential to lower the blood sugar levels too much and cause hypoglycemia, especially in older adults. Patients taking sulfonylureas should avoid alcohol to avoid a disulfiram-like reaction. Importantly, sulfonylureas are sulfa drugs and may therefore cause drug allergies in certain patients - be sure to look out for a history of allergic reactions before giving the drug!
Key Points
- Sulfonylureas
- Key drugs
- Glimepiride
- Glipizide
- Glyburide
- Mechanism
- Directly stimulates beta cells in the pancreas to release more insulin, thus decreasing blood glucose level
- Increases tissue response to insulin
- Decreases glucose production by the liver
- Clinical Use
- Hyperglycemia in Type II Diabetes Mellitus
- Is most effective if administered 30 minutes before a meal
- Hyperglycemia in Type II Diabetes Mellitus
- SE and AR
- Hypoglycemia
- Shakiness
- Tachycardia
- Weakness
- Diaphoresis
- Use extreme caution in the elderly
- Avoid alcohol
- When combined with alcohol, sulfonylureas may cause a disulfiram-like reaction (nausea, vomiting, chills, headache, “hangover” like symptoms)
- Alcohol can also potentiate the hypoglycemia and lower blood glucose levels even further
- Hypersensitivity / Allergy (Sulfa Allergy)
- If a patient has had an allergic reaction to another sulfa-derivative drug (e.g. sulfonamides, thiazide diuretics) the order for sulfonylureas should be questioned
- Weight gain
- Photosensitivity
- Hypoglycemia
- Key drugs