Sulphonylurea drugs

Gulliford M, Latinovic R. Mortality in type 2 diabetic subjects prescribed metformin and sulphonylurea drugs in combination cohort study. Diabetes Metab Res Rev... 

G. Muller, E. A. Dearey, and J. Punter, The sulphonylurea drug, glimepiride, stimulates release of glycosylphosphati-dylinositol-anchored plasma membrane proteins from 3T3 adipocytes, Biochem. 

Beneficial results in the glycemic profile (mean reduction of fasting glucose by about 0.8 mmol/L) have been reported with orlistat-induced weight loss in 6- to 12-month studies in obese type 2 diabetic patients. This has been found also when orlistat was given as an adjunct to antidiabetic treatment such as with metformin and sulphonylurea drugs. Smaller but significant reductions of HbAlc have also been found by orlistat treatment (placebo controlled). 

Broadway, N.M. Saggerson, E.D. (1995) FEBS Lett., 371, 137-139. Inhibition of liver microsomal carnitine acyltransferases by sulphonylurea drugs. 

Metabolism Hypoglycaemia In a study carried out over a 6-month period, sitagliptin was given to 60 patients (46 men and 14 women) with type 2 diabetes. There were two episodes of mild hypoglycaemia, both of which occurred in patients concomitantly receiving sulphonylurea drugs. [37 ]... 

Antidiabetic Drugs other than Insulin. Figure 1 Sulphonylureas stimulate insulin release by pancreatic (3-cells. They bind to the sulphonylurea receptor (SUR-1), which closes Kir6.2 (ATP-sensitive) potassium channels. This promotes depolarisation, voltage-dependent calcium influx, and activation of calcium-sensitive proteins that control exocytotic release of insulin. 

Acetazolamide is a carbonic anhydrase inhibitor that reduces aqueous humour production and is therefore indicated in glaucoma to reduce the intraocular pressure. Salbutamol is a selective, short-acting beta2-agonist used as a bronchodilator in asthma. Tolbutamide is a short-acting sulphonylurea used in type 2 (non-insulin dependent) diabetes mellitus. Chlorpromazine is an aliphatic neuroleptic antipsychotic drug used in schizophrenia. Zafirlukast is a leukotriene-receptor antagonist that is indicated in the prophylaxis of asthma but should not be used to relieve acute severe asthma. 

RendeU M. The role of sulphonylureas in the management of type 2 diabetes melhtus. Drugs 2004 64 1339-58. 

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. 

II.f.2.2. Sulphonylureas. These drugs stimulate pancreatic /3-cell insulin secretion, reduce serum glucagon levels, potentiate insulin action on target tissues, and improve /3-cell function. The sulphonylureas differ in their potency, extent of hepatic metabolism, hypoglycaemic activity of their metabolites, renal excretion, peak and duration of action, side effects and costs. 

Hansen JM, Christensen LK. Drug interactions with oral sulphonylurea hypoglycaemic drugs. Drugs 1977 13(l) 24-34. 

The use of oral antidiabetic drugs may be necessary. Insuhn production is initially only moderately impaired in type 2 diabetes, so oral medication can often be used to improve insulin production (e.g. sulphonylureas), to regulate inappropriate release of glucose by the liver and attenuate insulin resistance to some extent (e.g. metformin), and to substantially attenuate insulin resistance (e.g. thiazohdinediones). A Hnal resort is insuhn therapy to maintain normal or near-normal glucose levels. 

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