I’m going to cover sulfonylureas tonight; this class is a mainstay in the treatment Type 2 diabetes. Other than metformin, these drugs are probably the most frequent oral class used. The most frequent names that come to mind are glipizide, glimepiride, and glyburide…the “g” drugs. In the most simple way to describe these drugs, they increase the body’s production of insulin – therefore lowering blood glucose. I have seen chlorpropamide (another sulfonylurea) a few times, but this drug is rarely used due to potential problems of hypoglycemia or SIADH – per Lexicomp. I have not personally seen SIADH from chlorpropamide, but hardly anyone is on this drug especially in the elderly population. Hypoglycemia, hypoglycemia, hypoglycemia is primarily the biggest concern with these medications because they cause the release/production of more insulin. Glyburide use is not recommended with a creatinine clearance less than 50 mls/min per Lexicomp; glipizide is generally preferable in kidney disease.
Written By Eric Christianson
November 30, 2013
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