Sulfonylureas glipizide

Insulin secretagogues Sulfonylureas Glipizide Chlorpropamide, tolbutamide, tolazamide, glimepiride, glyburide... 

The client diagnosed with T e 2 diabetes is prescribed the sulfonylurea glipizide... 

Nauck MA, Meininger G, Sheng D, Terranella L, Stein P. Efficacy and safety of the dipeptidyl peptidase-4 inhibitor, sitagliptin, compared to the sulfonylurea, glipizide, in patients with type 2 diabetes inadequately controlled on metformin alone A randomized, double-blind, non-inferiority trial. Diabetes Obesity Metab 2007 9 194-205. 

Drug/Food interactions Absorption of glipizide is delayed by approximately 40 minutes when taken with food the drug is more effective when given approximately 30 minutes before a meal. The other sulfonylureas may be taken with food. 

Sulfonylureas, such as glipizide and glyburide, and meglitinides, such as repaglinide and nateglin-ide, stimulate insulin secretion by the beta cells. 

Glucotrol (Glipizide) 10.7 (0.5) 14.1 (0.5) 13.1 (0.6) A second generation sulfonylurea that blocks ATP-sensitive K-channels in the membrane of beta cells, stimulating the release of insulin. 

Hepatitis after sulfonylureas is known, and this patient had taken glipizide for several years. The combination of glipizide and metformin may have been to blame. 

Water retention with oliguria, uremia, and edema has been reported with gliclazide (76). Resistance to diuretics can be caused by chlorpropamide (77) or, to a lesser extent, tolbutamide. Changing to a sulfonylurea without an antidiuretic effect (glibenclamide) or to one that enhances water excretion (acetohexamide, glipizide, or tolazamide) (78) may be advisable. 

The risk of hepatotoxicity with the sulfonylureas varies with both the drug and the dosage. It has been described with chlorpropamide (95), tolazamide (96), tolbutamide (97), glipizide (98), and glibenclamide (99). Anicteric, cytolytic hepatitis has been described after glibenclamide (100). 

Severe hypoglycemia occurred in two elderly men with type 2 diabetes mellitus and mild to moderate impaired renal function, who took clarithromycin 1000 mg/day for respiratory infections, in addition to a sulfonylurea (glibenclamide 5 mg/day in one case and glipizide 15 mg/day in the other) (168). Both developed severe hypoglycemia within 48 hours of starting clarithromycin. 

The sulfonylureas stimulate insulin secretion by pancreatic cells. As an old class of diabetes drug, the sulfonylureas have been improved steadily over the years. The original sulfonylurea is tolbutamide (A.66) (Figure A.21). Later and more potent sulfonylureas include glipizide (Glucotrol, A.67), glyburide (A.68), and finally glimepiride (Amaryl, A.69). 

New formulations of some sulfonylureas offer the possibility of once-daily therapy. They include gliclazide MR (SEDA-25, 511) and glipizide GITS (SEDA-22, 444) (SEDA-23, 475). 

Sulfonylureas (e.g., glipizide 1) and meglitidines (e.g., repaglinide 2) are insulin secretagogues, which act directly on pancreatic islet (3-ceUs to close ATP-sensitive potassium ion channels in the cell membrane. This increases intracellular calcium and indirectly facilitates secretion of insulin in response to the presence of glucose [50]. 

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