Sulphonylureas

All orally effective, can be used in type 1 individual as supplement to insulin. Their half-lives vary a little. They have high plasma protein binding. There is a serious issue, NSAIDs especially compete for the same binding site that sulfonylurea binds to. If you add an NSAID to a pt taking a sulfonlyurea drug they will displace the drug. The duration of action can range from a ½ to a full day. The choice between the different sulfonylurea drugs is very subtle.


Insulin is the only drug effective for diabetes type 1. The oral hypoglycemic agents are primarily designed for type 2, but some type 2 diabetics do need insulin to get under tight control (the insulin must be injected). If a pt is not controlled by the highest possible sulfonylurea dose, if they were to get into within 10% of their appropriate weight and exercise moderately (walking, swimming…) the requirement of their sulfonylurea dose decreases markedly, some pts can stop taking the drug altogether. So you ask: Why don’t all diabetics lose weight and start exercising? Its like anything else, how do you modify behavior? That discipline is called barostatic medicine.


Metformin is seen most frequently in clinic, it doesn’t release insulin from the pancreatic beta cells, but facilitates the transport of glucose.

Category: Pharmacology Notes