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Sulfonylureas are oral hypoglycemic agents used in the management of type 2 diabetes. Sulfonylureas can cause hypoglycemia and are, therefore, not first-line drugs for managing type 2 diabetes. Overview of the Drug Class **Prototype: glyburide (DiaBeta) ** - **Category**: Sulfonylurea (Oral Hyp...

Sulfonylureas are oral hypoglycemic agents used in the management of type 2 diabetes. Sulfonylureas can cause hypoglycemia and are, therefore, not first-line drugs for managing type 2 diabetes. Overview of the Drug Class **Prototype: glyburide (DiaBeta) ** - **Category**: Sulfonylurea (Oral Hypoglycemic Agent)  - **Primary Function**: Sulfonylureas are oral hypoglycemic agents primarily used to manage type 2 diabetes.  - **Unique Features**: Sulfonylureas are categorized into first and second generations, with second-generation drugs being more commonly used due to their increased potency and shorter duration of action. This interactive book covers second-generation sulfonylureas only.  Mechanism of Action - Sulfonylureas stimulate the release of insulin from pancreatic beta cells by binding with and blocking adenosine triphosphate (ATP)-sensitive potassium channels in the cell membrane, causing membrane depolarization, calcium influx, and insulin release. The release of insulin by sulfonylureas is glucose-dependent, which means they are effective in lowering blood glucose levels when glucose is present but can also pose a risk for hypoglycemia if not managed correctly.  Indications and Therapeutic Uses - **Diabetes**: Sulfonylureas are utilized to improve glycemic control in clients with type 2 diabetes. Side Effects and Adverse Reactions **Side Effect** **Description** ------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Hypoglycemia Because sulfonylureas actively drive down blood sugar by stimulating insulin release, they can cause this side effect. Clients should be educated about signs, symptoms, and monitoring requirements. Cardiovascular Toxicity This side effect is a concern with first-generation sulfonylureas only, although studies have been inconclusive. Precautions and Contraindications **Precautions** - Use with caution in clients with hepatic or renal impairment, as these conditions can affect drug metabolism and excretion, increasing the risk of adverse effects.  **Contraindications** - Contraindicated in pregnancy due to the risk of neonatal hypoglycemia and potential teratogenic effects observed in animal studies.  - Contraindicated in breastfeeding clients due to the risk of infant hypoglycemia.  Drug Interactions - Sulfonylureas can interact with other hypoglycemic agents, including **\[alcohol, non-selective beta-blockers, and insulin\]**, increasing the risk of hypoglycemia.  - All **\[beta-blockers\]** can mask hypoglycemia by blocking tachycardia, delaying awareness of decreasing blood sugar.  Dosing, Administration, & Client Teaching **Dosing** - Dosing varies based on the condition, severity, and client response.  - Check drug dosing guidelines for individualized dosing.  - Dosed orally, once or twice daily, depending on the specific drug and client\'s blood glucose control needs.  - Ensure clients know the risks of hypoglycemia and how to monitor for and treat it.  - These medications are only indicated for treatment regimens if medication access or cost is an issue for clients.  **Administration** - PO administration.  **Client Teaching** - Clients should regularly monitor their blood glucose levels to avoid hypoglycemia.  - Clients should be educated in recognizing the signs and symptoms of hypoglycemia and how to manage it should it occur.  - Advise clients who are pregnant or attempting to become pregnant to discuss with their provider as sulfonylureas are not safe in pregnancy or breastfeeding.  Labs to Monitor **Basic Metabolic Panel (BMP)** - A BMP can be used to monitor blood glucose levels and kidney function.  **Hemoglobin A1c** - Monitoring hemoglobin A1c will provide information on the effectiveness of the treatment regimen.