Week 8: Sulfonylureas and Megalitinides - Insulin Secretagogues

Question 1

Sulfonylureas - Glipizide (Glucotrol), glyburide (Diabeta), glimepiride (Amaryl) MOA

Answer 1

• stimulates an increase in secretion of insulin from beta cells
• reduce glucose release from the liver
• insulin secretagogues (NEED INSULIN TO WORK!)

Question 2

Sulfonylureas (Glucotrol, Diabeta, Amaryl) ADRs

Answer 2

• MOST potential for Hypoglycemia
• Weight gain
• Agranulocytosis (rare)

Question 3

Sulfonylureas Contraindications

Answer 3

NO elderly, preg, lac, < 18 yrs

-sulfa allergy

Question 4

Sulfonylureas (Glucotrol Diabeta, Amaryl) Pt education

Answer 4

• take with food - if you skip a meal, skip dose

Question 5

Megilitinides - Repaglinide (Prandin), nateglinide (Starlix) MOA “glinides”

Answer 5

MOST EFFECTIVE at reducing post prandial blood glucose levels

• block K channels and letting in Ca –> high Ca stimulates insulin release from pancreatic beta cells
• need insulin for this
• short acting insulin secretagogues

Question 6

Megilitinides ADRs

Answer 6

• hypoglycemia
• weight gain
• chest or back pain

Question 7

Megilitinides (Prandin, Starlix) contraindications

Answer 7

NO pregnancy, lactation, and pediatrics, elderly (hypoglycemia = falls)
- caution renal/hepatic impairment

Question 8

Megilitinides (prandin, starlix) patient education

Answer 8

• take with food; no more than 30 minutes before a meal

- hold if not eating