Glucose hypoglycemic agents

Hypoglycemic agent. A drug that lowers glucose concentrations in the blood. 

Lifestyle modifications are always in order in patients who have developed or those who are at increased risk of developing NODAT.74 Insulin therapy and oral hypoglycemic agents are used often (Table 52-8) in patients in whom lifestyle modifications alone have not controlled blood glucose levels. See Chapter 40 for appropriate treatment regimens for diabetes. 

Diabetes me///fws Triamterene may raise blood glucose levels for adult-onset diabetes dosage adjustments of hypoglycemic agents may be necessary. Concurrent use with chlorpropamide may increase the risk of severe hyponatremia. Photosensitivity Photosensitization is likely to occur avoid prolonged exposure to sunlight. 

Hypomania Hypomania has been the most common severe psychiatric side effect reported. This has been largely limited to patients in whom disorders characterized by hyperkinetic symptoms coexist with, but are obscured by, depressive affect. Diabetes There is conflicting evidence as to whether MAOIs affect glucose metabolism or potentiate hypoglycemic agents. Consider this if used in diabetics. Epilepsy The effect of MAOIs on the convulsive threshold may vary. Do not use with metrizamide discontinue MAOl 48 hours or more prior to myelography and resume 24 hours postprocedure. 

Biood giucose abnormaiities Disturbances of blood glucose, including symptomatic hyper- and hypoglycemia, have been reported, usually in diabetic patients receiving concomitant treatment with an oral hypoglycemic agent or with insulin. 

When lifestyle changes alone are insufficient to manage blood glucose levels, a variety of hypoglycemic agents can be used. 

However, contrary to popular belief, beta-adrenoceptor antagonists do not by themselves increase the risk of hypoglycemic episodes in insulin-treated diabetics, in whom their use was concluded to be generally safe (184). Indeed, in 20 such patients treated with diet or diet plus oral hypoglycemic agents, both propranolol and metoprolol produced small but significant increases in blood glucose concentrations after 4 weeks (185). The rise was considered clinically important in only a few patients. 

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