- Used by persons w/ NIDDM - should NOT be used by persons w/ IDDM
- NIDDM has some degree of insulin secretion by pancreas
- Several classes of oral hypoglycemic agents
- Sulfonylureas - First & Second generation
- - Chemically related to sulfonamides, but lack antibacterial activity - stimulate the beta cells to secrete more insulin
- - 1st generation divided into short, intermediate & long acting antidiabetics
Antidiabetic Agents Oral Agents - - tolbutamide (Orinase) - short; Tolazamide (Tolinase) - intermediate; Chlorpropamide (Diabinese) - long
- - Action - Stimulate beta cells to secrete insulin
- - Use NIDDM
- - SE - similar to insulin - hypoglycemic rxn w/o adequate food intake
- - DI - ASA, anticoagulant, anticonvulsants, sulfonamides, & some NSAIDs can inc. action of sulfonylureas an insulin rxn
Antidiabetic Agents Oral Agents - Nonsulfonylurease: Newer drugs
- Biguanides: Metformin (Glucophage)
- - Decreases hepatic production of glucose from stored glycogen = diminishes the inc. in serum glucose after a meal
- - Dec. the absorption of glucose from the small intestine
- - Evidence it inc. insulin receptor sensitivity
- - Does not produce hypo or hyperglycemia
- - SE - N &V, anorexia, abd cramping, gas
- - Can be combined w/ a sulfonylurea & insulin
Antidiabetic Agents Oral Agents - Alpha-Glucosidase Inhibitor: Acarbose (Precose)
- - Action - inhibits the digestive enzyme in sm. intestine responsible for release of glucose from the complex carbohydrates (CHO) in the diet
- - By inhibiting alpha glucosidase (enzyme) - the CHO cannot be absorbed & they pass into the lg. intestine
- - does not cause a hypoglycemic rxn
- - Use - for clients who do not achieve results on diet alone
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