Sulfonylureas adverse effects

The most common adverse effect associated with sulfonylurea administration is hypoglycemia, which may be provoked by inadequate calorie intake (e.g., skipping a meal), or increased caloric needs (e.g., increased physical activity). Collectively, sulfonylureas also tend to cause weight gain, which is undesirable in individuals... 

All sulfonamides, including antimicrobial sulfas, diuretics, diazoxide, and the sulfonylurea hypoglycemic agents, have been considered to be partially cross-allergenic. Flowever, evidence for this is not extensive. The most common adverse effects are fever, skin rashes, exfoliative dermatitis, photosensitivity, urticaria, nausea, vomiting, diarrhea, and difficulties referable to the urinary tract (see below). Stevens-Johnson syndrome, although relatively uncommon (ie, < 1% of treatment courses), is a particularly serious and potentially fatal type of skin and mucous membrane eruption associated with sulfonamide use. Other unwanted effects include stomatitis, conjunctivitis, arthritis, hematopoietic disturbances (see below), hepatitis, and, rarely, polyarteritis nodosa and psychosis. 

Exenatide (synthetic exendin-4, from the saliva from a lizard), which has a 53% overlap with glucagon-like peptide-1 and which also binds to the glucagon-like peptide-1 receptor, has been investigated in a placebo-controlled study for 28 days in 116 patients with type 2 diabetes in addition to a sulfonylurea or metformin (1). The most common adverse effects were nausea (mostly only in the first week) and mild to moderate hypoglycemia, for which no treatment was needed. 

Adverse effect Hypoglycemia due to sulfonylureas Dose-relation toxic effect Time-course time-independent Susceptibility factors disease (impaired liver or kidney function, alcoholism) drug interactions reduced food intake exercise... 

The addition of hydroxychloroquine to sulfonylureas has been investigated in a placebo-controlled study in 125 adipose patients whose diabetes was not well enough controlled with a sulfonylurea alone (179). During the first six months HbAlc was significantly reduced by 1.02%. There were no significant differences in adverse effects, but those who took hydroxychloroquine had a greater incidence of minor corneal changes. 

Adverse effect Hypoglycemia due to sulfonylureas Dose-relation toxic effect Time-course time-independent... 

Tolmetin Sodium, USP. Tolmetin sodium. I-methyl-5-(p-toluoyl)pyrrule-2-acetate dihydrate sodium. McN-25.<9 (Tolectin). is an arylacetic acid derivative with a pyrrole a- the aryl group. This drug is absorbed rapidly, with a lela-tivcly short plasma half-life (I hour). It is recommended for use in the management of acute and chronic RA. It shm- similar, but le.ss frequent, adverse effects with aspirin. Il doe-not potentiate coumarin-like drugs nor alter the Mood levels of sulfonylureas or insulin. Like other drugs in this class, it inhibits prostaglandin synthetase and lowers PCE blood levels. 

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