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Diabetes is one of the commonest endocrine ailments that is experienced by the patients who require treatment using psychoactive drugs. In recent years, there has been an increase in the number of pharmacotherapy options which are categorized as either hypoglycemic drugs, pharmacologic classes, or the more common insulin. The different comorbidities occasion the use of various drugs. Indeed, the diverse nature of the drugs has made it necessary for clinicians to have knowledge about the possibility of potential drug interactions. Sulfonylureas and meglitinides are classes of oral hypoglycemic drugs that have the ability of directly stimulating the release of insulin from the pancreatic beta cells. The use of these drugs together carries with it particular side effects, efficacy and indications. This paper is aimed at identifying a drug to drug interaction and pharmacotherapeutics on sulfonylureas and meglitinides.
Drug to drug interaction is the interference that affects the effects of a particular drug because of the co-administration of another drug. The drug interaction will either lead to an increased benefit to the patient or have increased adverse effects. Particular chronic disorders such as diabetes have a higher risk of the adverse drug to drug interaction. Indeed, it is possible that the interaction will alter the pharmacodynamic profile of the other.
Insulin secretagogue therapy is a commonly used form of treatment in clinical practice. The agents are either utilized as first or second line therapy behind metformin treatment of type 2 diabetes mellitus. Sulfonylureas and meglitinides have been identified as effective treatments for the increased release of insulin. However, research conducted over many years spanning decades has raised pertinent issues and concerns towards their universal prescription. The issues include ischemic pre-conditioning blunting, insulin secretagogue therapy's role in v-cell failure, weight gain, hypoglycemia incidences in the at-risk population, and the unproven cancer links.
Sulfonylureas are the oldest most commonly used drugs for the treatment of diabetes patients. It allows and stimulates the release of insulin as well as calcium influx. They are best used as mono-therapy although they can also be used in combination with other hypoglycemic oral drugs or insulin. They are not suited for older patients as there is the possibility of an increased incidence of hypoglycemia. Shorter-acting drugs should be used for this case. The most common side effect is hypoglycemia and patients need to be cautioned against situations that have higher risks of hypoglycemia.
Meglitinides, on the other hand, are cousins to sulfonylureas. They work in much the same way as sulfonylureas as they also increase insulin secretion. Their difference is that they have a shorter action time. Repaglinide and nateglinide are common meglitinides. Due to their fast acting nature, they must be taken right before meals and should not be taken on the occasion where one misses a meal. They also have hypoglycemia as potential side effects as well as weight gain and gastrointestinal upset. They are also taken together with other drugs such as gemfibrozil, beta blockers, and blood thinners. They cannot be taken together with sulfonylureas.
In conclusion, sulfonylureas and meglitinides are insulin secretors that are a must-have for diabetes patients. They have the same usage although one is fast acting whereas the other takes some time. In the end, the doctor will prescribe the drug that best suits the patient. The drugs can be used in conjunction with other drugs to treat diabetes albeit they have particular effects with the commonest being hypoglycemia.
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