Oral Hypoglycemic Drug Classes

Oral Hypoglycemic Drug Classes

• Common classes include Sulfonylureas, Biguanides, Alpha Glucosidase Inhibitors, Thiazolidinediones (Glitazones), Meglitinides, and Incretin Enhancers.

Sulfonylureas - Action and Adverse Drug Reactions (ADRs)

• Stimulate insulin release from pancreatic beta cells and increase insulin receptor sensitivity on target cells.
• Most common ADR is hypoglycemia, especially when medication is taken without adequate food intake.

Examples of Sulfonylureas

• Glipizide (brand name Glucotrol)
• Glimepiride (brand name Amaril)
• Glyburide (brand name Micronase)

Biguanides

• Prototype drug is Metformin.
• Decreases gluconeogenesis and reduces insulin resistance.
• Promotes weight loss and lowers LDL cholesterol; does not stimulate insulin release, hence does not cause hypoglycemia.
• Potential ADR includes lactic acidosis.

Alpha Glucosidase Inhibitors

• Block enzymes in the small intestine that break down complex carbohydrates into monosaccharides, delaying glucose digestion.
• Generally well tolerated with minimal ADRs, primarily gastrointestinal in nature.

Examples of Alpha Glucosidase Inhibitors

• Acarbose (brand name Precose)
• Miglitol (brand name Glyset)

Thiazolidinediones (Glitazones)

• Decrease blood glucose by reducing insulin resistance and inhibiting hepatic gluconeogenesis.
• Optimal glucose lowering effect occurs within 3-4 months.
• Common ADRs include fluid retention, weight gain, and headache; carries a Black Box warning for heart failure.
• Hypoglycemia is not typically a side effect.

Examples of Glitazones

• Pioglitazone (brand name Actos)
• Rosiglitazone (brand name Avandia)

Meglitinides

• A newer class of oral hypoglycemic medications.
• Stimulate the release of insulin from pancreatic islet cells with a short duration of effect (2-4 hours).
• Common ADR is hypoglycemia, though generally well tolerated.

Example of Meglitinide

• Repaglinide (brand name Prandin)

Incretin Enhancers

• Hormones secreted by the small intestine in response to elevated blood glucose levels.
• Promote insulin secretion from the pancreas and inhibit glucagon production in the liver.
• Lower blood glucose levels without causing hypoglycemia.
• Common ADRs include nausea/vomiting and diarrhea; work effectively with other diabetic medications.

Examples of Incretin Enhancers

• Subcutaneous options: Exenatide (brand name Byetta), Liraglutide (brand name Victoza).
• Oral option: Linagliptin (brand name Tradjenta).

Explore the various classes of oral hypoglycemic drugs, including their actions and potential adverse drug reactions. This quiz covers Sulfonylureas, Biguanides, and other drug types, providing insight into their mechanisms and examples. Test your knowledge and understanding of these essential diabetes medications.