Sulphonylureas

Question 1

Give 2 examples of short acting sulphonylureas

Answer 1

• Gliclazide

- Tolbutamide

Question 2

Give 2 examples of long acting sulphonylureas

Answer 2

• Glibenclamide

- Glimpiride

Question 3

What is the disadvantage of long-acting sulphonylureas

Answer 3

More likely to cause hypoglycaemia

Question 4

What is the mechanism of action of sulphonylureas?

Answer 4

Stimulate insulin secretion from the pancreatic beta cells

Question 5

What is the route of delivery of sulphonylureas?

Answer 5

PO

Question 6

What are the indications for sulphonylureas?

Answer 6

T2DM

Question 7

What are the contraindications to sulphonylureas?

Answer 7

Ketoacidosis

Question 8

Can sulphonylureas be used in pregnancy and breastfeeding?

Answer 8

Some should be avoided due to risk of hypoglycaemia in the infant

Question 9

When should sulphonylureas be used with caution?

Answer 9

• Elderly

- Those with G6PD deficiency

Question 10

What might interact with sulphonylureas?

Answer 10

• Insulin
• Other anti-diabetic drugs
• Alcohol
• ACEi
• Warfarin

Question 11

What might happen if insulin/other anti-diabetic drugs or alcohol are given with sulphonylureas?

Answer 11

Increased risk of hypoglycaemia

Question 12

What might happen if ACEi or warfarin are given with sulphonylureas?

Answer 12

These drugs possibly enhance the hypoglycaemic effect of sulphonylureas

Question 13

What monitoring is required with sulphonylureas?

Answer 13

Monitoring of blood glucose and body weight during therapy

Question 14

What are the less common side effects of sulphonylureas?

Answer 14

• Hypoglycaemia
• GI upset
• Weight gain
• Blood disorders, e.g. aplastic anaemia, agranulocytosis

Question 15

What are the other side effects (frequency not known) of sulphonylureas?

Answer 15

• Hypersensitivity reactions

- Erythema multiforme

Question 16

What patient counselling is required with sulphonylureas?

Answer 16

• Mode of action
• How to take
• Preventing hypoglycaemia
• Weight gain
• Surgery
• Driving advice

Question 17

What should the patient be told regarding mode of action of sulphonylureas?

Answer 17

Explain that this medication will help reduce the patient’s blood sugars by helping the body produce more insulin. This medication will not cure the patients diabetes, and they will need to maintain a healthy diet and exercise regularly

Question 18

What should the patient be told about how to take sulphonylureas?

Answer 18

With food

Question 19

What should the patient be told about preventing hypoglycaemia with sulphonylureas?

Answer 19

Educate patients about signs of hypoglycaemic attack and provide instructions about what to do if the patient or peoples in the patients surroundings should do in the event of a hypoglycaemic attack

Question 20

What should the patient be told about weight gain with sulphonylureas?

Answer 20

Warn patients that there is a risk of weight gain so it is important to monitor their weight

Question 21

What should the patient be told about surgery with sulphonylureas?

Answer 21

Drugs usually omitted on the morning of surgery