Hypoglycemic drug

Meglitinide contains a benzamide group. Meglitinide-related compounds such as nateglinide are non-sulfonylurea oral hypoglycemic drugs used in the treatment of type 2 (non-insulin dependent) diabetes mellitus. 

Sulfonamides may inhibit the (hepatic) metabolism of the oral hypoglycemic drugs tolbutamide (Orinase) and chloq ropamide (Diabinese). This would increase the possibility of a hypoglycemic reaction. 

The effects of oral hypoglycemic drugs, oral anticoagulants, and phenytoin may be increased when administered with chloramphenicol. Fhenobarbital or rifampin may decrease chloramphenicol blood levels. 

Large doses of IValbuterol or IV terbutaline may aggravate diabetes mellitua Diabetic patients may require an increase in insulin dosage or oral hypoglycemic drug. 

Initial dose - 1 to 2 mg once daily, given with breakfast or the first main meal. Patients sensitive to hypoglycemic drugs should begin at 1 mg once daily titrate carefully. 

Initial dose 2.5 to 5 mg/day, administered with breakfast or the first main meal. For patients who may be more sensitive to hypoglycemic drugs, start at 1.25 mg/day. 

The administration of oral hypoglycemic drugs The administration of oral hypoglycemic drugs has been associated with increased cardiovascular mortality as compared with treatment with diet alone or diet plus insulin. 

Tolazamide (Tolinase) is an orally effective hypoglycemic drug that causes less water retention than do the other compounds in this class. 

D. One of the most important therapeutic objectives is to maintain normal glucose levels without producing frequent hypoglycemia. The main class of hypoglycemic drugs that have a propensity to cause hypoglycemia are the sulfonylureas, of which gly-buride is one. This is not a problem with the other choices. 

Diuretics like frusemide may attenuate the effects of oral hypoglycemic drugs. 

Oral hypoglycemic drugs have been associated with increased cardiac mortality as compared to treatment with diet alone or diet and insulin... 

TREATMENT WITH ORAL HYPOGLYCEMIC DRUGS i I Unresponsive Responsive... 

TREATMENT Insulin is always necessary I Diet, exercise, oral hypoglycemic drugs, +/- insulin... 

Glucocorticoids increase chromium losses and glucocorticoid-induced diabetes can be reversed by chromium supplementation (133). Doses of hypoglycemic drugs were also reduced by 50% in all patients when they were given supplementary chromium. 

When acarbose is combined with insulin, the greatest effects are seen with regimens that involve only once- or twice-daily administration. The alpha-glucosidase inhibitors seem to be less effective when they are combined with intensive insulin therapy (35). In combination with insulin or oral hypoglycemic drugs the frequency of hypoglycemic episodes can increase sucrose or higher carbohydrates are reported to be less effective, which can be understood from the mechanism of action. 

The different mechanisms of action of the various classes of hypoglycemic drugs makes combined therapy feasible the sulfonylureas and meglitinides stimulate insulin production by different mechanisms, the biguanides reduce glucose production by the liver and excretion from the liver, acarbose reduces the absorption of glucose from the gut, and the thiazolidinediones reduce insulin resistance in fat. It is not necessary to wait until the maximal dose of... 

Metformin has been reviewed, with special attention to therapy in combination with other hypoglycemic drugs (15). The general conclusions were that it can effectively lower HbAic concentrations, Improve lipid profiles, and improve vascular and hemodynamic indices. 

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