Sulphonylurea derivatives

Lao B, Czyzyk A, Szutowski M, Szczepanik Z. Alcohol tolerance in patients with non-insu-lin-dependent (type 2) diabetes treated with sulphonylurea derivatives. Arznemdtteybrs[Pg.475]

II.f.2.1. Oral hypoglycaemic agents. There are now five groups of orally active drugs available to lower blood glucose in clinical practice (Table 2). These are sulphonylureas, biguanides, alpha-glucosidase inhibitors, thiazolidinediones, and the incretin derivatives. 

U-56324 (28), a nicotinic acid derivative, has hypoglycaemic activity in the 18-h fasted normal rat [173] and stimulates in vitro insulin secretion [174]. Study of the in vitro activity in membrane patches from cultured mouse pancreatic jff-cells revealed that it acts directly on ATP-sensitive potassium channels and probably has the same mechanism of action as sulphonylureas [174]. 

Exanthematic/maculopapular reactions are the most frequent unlike a viral exanthem the eruption typically starts on the trunk the face is relatively spared. Continued use of the drug may lead to erythroderma. They commonly occur at about the ninth day of treatment (or day 2-3 in previously exposed patients), although onset may be delayed until after treatment is completed causes include antimicrobials, especially ampicillin, sulphonamides and derivatives (sulphonylureas, frusemide (furosemide) and thiazide diuretics). Morbilliform (measles-like) eruptions typically recur on rechallenge. 

Oral antidiabetes drugs are of two kinds sulphon-amide derivatives (sulphonylureas) and guanidine derivatives (biguanides). They are used by 30% of all diabetics. Unlike insulin they are not essential for life. 

Leucine, ethanol, tobacco, the salicylates, hypoglycin A and B, pent-4-enoic acid, ouabain, isoproterenol, mesoxalate, tris-(hydroxymethyl)-aminomethane (Tham or Tris), cyclopropane carboxylic acid, monoamine oxidase (MAO) inhibitors, a few derivatives of indole, tranylcypromine and some cyclic polycarbonyls such as rhodizonate and tetrahydroxyquinone may be included among these substances. Leucine stimulates insulin secretion in infants with leucine sensitivity as well as in normal adults, especially if infused in large amounts or if the p cells have been primed by the previous administration of a sulphonylurea. 

---