Hypoglycemic agent

Table 2. Sulfonylureas Used as Oral Hypoglycemic Agents...

Development of hypoglycemic agent troglitazone (CS-045). 6-hydroxy-2-[p-(2,4-dioxothiazolidin-5-ylmethyl)phenoxymethyl]-2,5,7,8-tetramethylchro-mane 97YZ597. 

Yet another example of a so-called pharmacophoric group is the biguanide functionality, a grouping associated with oral antidiabetic activity (see the section on sulfonylureas for a fuller discussion of this activity). Condensation of 2-phenethylamine with dicyanamide affords directly the orally active hypoglycemic agent phenformin (88). ... 

Treatment of piperidine with nitrous acid affords the N-nitroso derivative (190) reduction gives the corresponding hydrazine (191). Condensation of this intermediate with the carbamate (192) obtained from p-toluenesulfonamide leads to the oral hypoglycemic agent tolazemide (193). In a similar vein, reaction of the hydrazine obtained by the same sequence from azepine (194) with the carbamate, 188, gives azepinamide (195). ... 

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

A related agent, g1 icetanile sodium (42), is made b / a variant of this process. Methyl phenyl acetate is reacted with chlorosulfonic acid to give 38, which itself readily reacts with aminopyrimidine derivative 39 to give sulfonamide Saponification to acid 4 is followed by conversion to the acid chloride and amide formation with 5-chloro-2-methoxyaniline to complete the synthesis of the hypoglycemic agent glicetanile (42). ... 

Perhaps surprisingly, the p-methyl benzenesulfonylurea analogue called tosi fen (45), which is structurally rather close to the oral hypoglycemic agents, is an anti anginal agent... 

Amenorrhea, other menstrual irregularities, development of cushingoid state, suppression of growth in children, secondary adrenocortical and pituitary unresponsive (particularly in times of stress), decreased carbohydrate tolerance, manifestation of latent diabetes mellitus, increased requirements for insulin or oral hypoglycemic agents (in diabetics)... 

A QSAR for the acute toxicity of new hypoglycemic agents [48] was internally cross-validated, but used LD50 instead of log LD50 as the dependent variable, and (more seriously) used LD50 values in g kg rather than in a molar unit such as mmol kg. ... 

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. 

A 60-year-old diabetic male on an oral hypoglycemic agent develops abnormal liver function tests. Which of the following agents can cause this finding ... 

A 60-year-old male alcoholic treated for type 11 diabetes mellitus develops lactic acidosis. Which of the following oral hypoglycemic agents might cause this adverse effect ... 

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