Non sulfonylureas

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. 

FPG levels by 30 to 50 mg/dL (1.67-2.78 mmol/L), and the overall effect on HbAlc is a 1% to 1.5% reduction. Onset of action for thiazolidinediones is delayed for several weeks and may require up to 12 weeks before maximum effects are observed. Combining a sulfonylurea, non-sulfonylurea secret-agogue, metformin, or insulin with a thiazolidinedione can improve HbAlc reductions to 2% to 2.5%. 

Perffetti, R. Novel sulfonylurea and non-sulfonylurea drugs to promote the secretion of insulin. TEM 2000, 11 (6), 218-223. 

This drug is also a derivative of first generation of sulfonylurea, and it possesses stimulatory action on 8-cells in pancreas, as well as the same range of action as all other drugs of the group of examined compounds. Tolazamide is used for non-insulin-dependeut diabetes mellitus without expressed microvascular complications. Synonyms of this drug are uor-glycin, tolanase, and others. 

It is a very potent sulfonylurea with long duration of action indicated in non-insulin dependent (type II) diabetes, whenever blood sugar levels can not be controlled adequately by diet, physical exercise or reduction in body weight. 

Indication Monotherapy and in combination with a sulfonylurea, metformin, or insulin when diet and exercise plus the single agent does not result in adequate glycemic control in patients with type 2 diabetes (non-insulin-dependent diabetes millitus, NIDDM). 

A A female patient with non-insulin-dependent diabetes has been maintained on an oral sulfonylurea hypoglycemic agent. She becomes pregnant. The doctor switches her to insulin. This is necessary for all of the following reasons EXCEPT ... 

In the 1950s and 1960s, Geigy and other firms developed a series of herbicides based on alkyl and dialkyl triazines, such as the root-herbicide atrazine (83)64. They are made by stepwise introduction of suitable nucleophiles into precursors. Other members are ametryn, the non-selective simazine (84) and the cyanuric chloride-derived methylthio triazine desmetryne (85) (Scheme 19). Chlorotoluron is 3-(3-chloro-p-toly 1 )-1,1-dimethylurea (86), a phenylurea herbicide. These products act on the photosynthetic pathway. Both 83 and 84 are used for weed control in maize65. Sulfonylureas such as the triazine chlorosulfone (87) inhibit the enzyme acetolactate synthase. They offer the major advantage of requiring no more than 10 to 20 g per hectare. 

Trade names Dimelin Dimelor Dymelor (Barr) Indications Non-insulin dependent diabetes type II Category Sulfonylurea Half-life 1-6 hours... 

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