Antidiabetics
PREGNANCY CATEGORY B, C (GLYBURIDE, METFORMIN)
Therapeutic Actions
Oral antidiabetics include several drug types. One type, called the sulfonylureas, stimulates insulin release from functioning beta cells in the pancreas and may either improve binding between insulin and insulin receptors or increase the number of insulin receptors. Second-generation sulfonylureas (glipizide and glyburide) are thought to be more potent than first-generation sulfonylureas. Other types include drugs that increase insulin receptor sensitivity (thiazolidinediones); drugs that delay or alter glucose absorption (acarbose, miglitol); drugs that increase the stimulus for insulin release (DPP-4 inhibitors, incretin mimetics); and insulin, which is used for replacement therapy.
Indications
Adjuncts to diet and exercise to lower blood glucose in patients with type 2 (non–insulin-dependent) diabetes mellitus
Adjuncts to insulin therapy in the stabilization of certain cases of insulin-dependent maturity-onset diabetes, reducing the insulin requirement and decreasing the chance of hypoglycemic reactions
Replacement therapy in type 1 (insulin-dependent) diabetes mellitus and when oral drugs cannot control glucose levels in type 2 diabetes
Contraindications and Cautions
Contraindicated with allergy to sulfonylureas; diabetes complicated by fever, severe infections, severe trauma, major surgery, ketosis, acidosis, coma (insulin is indicated); type 1 diabetes, serious hepatic impairment, serious renal impairment, uremia, thyroid or endocrine impairment, glycosuria, hyperglycemia associated with primary renal disease; labor and delivery (if glipizide is used during pregnancy, discontinue drug at least 1 mo before delivery); lactation, safety not established.
Adverse Effects
CV: Increased risk of CV mortality
Endocrine: Hypoglycemia
GI: Anorexia, nausea, vomiting, epigastric discomfort, heartburn, diarrheaStay updated, free articles. Join our Telegram channel
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