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Antidiabetic drugs

Antidiabetic Agents Oral Agents

  • 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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