Question
Classify oral hypoglycemic drugs. Explain the mechanism of action, uses and side
effects of sulfonylureas. (2+2+1+1)
Q16 marksEssays
Answer
Classification of oral hypoglycaemic drugs
- Sulfonylureas: Glibenclamide, Glimepiride
- Biguanides: Metformin
- Alpha-glucosidase inhibitors: Acarbose
- Thiazolidinediones: Pioglitazone
- DPP-4 inhibitors: Sitagliptin
- SGLT2 inhibitors: Dapagliflozin
Mechanism of action of sulfonylureas
- Bind to SUR1 subunit of ATP-sensitive K⁺ channels on pancreatic β-cells, causing channel closure, membrane depolarization, calcium influx, and increased insulin secretion (insulin secretagogues)
- Require functioning β-cells to be effective
Uses
- Type 2 diabetes mellitus, particularly non-obese patients with residual β-cell function
Adverse effects
- Hypoglycaemia (most important, especially with glibenclamide)
- Weight gain
- GI upset
- Hypersensitivity reactions
- 1Diabetes Mellitus and Oral Hypoglycaemic Drugs
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