Sulphonylureas

Question 1

What is an example

Answer 1

Gliclazide

Question 2

What is the indication for use

Answer 2

Type 2 diabetes

- when metformin contraindicated or in combo with metformin

Question 3

What is the mechanism of action

Answer 3

• lower blood glucose by stimulating pancreatic insulin secretion
• Block ATP-dependent K+ channels in pancreatic beta cell membranes –> depolarisation + opening of voltage gated Ca2+ channels
• Increased intracellular Ca2+ conc stimulating insulin secretion

Question 4

What side effects are there

Answer 4

• Hypoglycaemia
• Hypersensitivity reactions
• hepatic toxicity - cholestatic jaundice
• Agranulocytosis
• Drug hypersensitivity syndrome

Question 5

What are the contra-indication

Answer 5

• Reduced hepatic impairment

- Caution in increased risk hypoglycaemia (malnutrition, adrenal/ pituitary insufficiency, elderly)

Question 6

What are the interactions

Answer 6

RISK OF HYPOGLYCAEMIA
- metformin
- thiazolidinediones
- insulin 
EFFICACY REDUCED (elevate glucose) 
- prednisolone
- thiazide 
- loop diuretics