Anti-diabetic Agents: Adverse Events

• Problems with insulin include hypoglycemia, local or systemic allergic reactions, visual disturbances, and peripheral edema. Hypoglycemia is the most important to moniter, must know the pt’s glucose level before an appt, make sure they are well controlled before beginning.
• Problems with sulfonylureas include hypoglycemia, gastrointestinal disturbances, hematological disturbances, flushing (especially with alcohol ingestion), contraindicated in pts with hepatic or renal insufficiency, and drug interactions.
• Problems with Metformin include lactic acidosis (more likely in pts with renal insufficiency in whom the drug can accumulate), and gastrointestinal problems.
• Problems with Acarbose include abdominal pain, diarrhea and flatulence (uh-oh… only make appointments on windy days, otherwise keep them out of your dental chair. Flatulence in the dental office is not a good practice-builder!)

Category: Pharmacology Notes