Chapter 51: Oral Antidiabetic Agents1STGENERATION SULFONYLUREAS (-amide)chlorpropamide (Diabinese) – use w/ caution in elderly2NDGENERATION SULFONYLUREAS (G- -ide)glimepriride (Amaryl)Increases insulin secretionAdminister:30 mins before mealsHave 10-15g carb readyS/E: hypoglycemia, weight gain,sulfa allergy, skin reaction (1stgen.) risk for hypoglycemia: elderly andrenal insufficiencyMonitor: s/s of hypoglycemia,glucose levels, urine ketonesIf taken with beta blockers, maymask signs of hypoglycemiaDrug-Drug Interactions:NSAIDS,warfarin, sulfonamidesInstruct to avoid alcoholBIGUANIDESmetformin (Glucophage, Fortamet)metformin with glyburide (Glucovance)Metforminalone–glucoseproduction by the liverCombo– also increases bodytissues’ sensitivity to insulinAdminister:with food to decreaseGI distressS/E:lactic acidosis, hypoglycemia IFcombined risk of hypoglycemia if usedaloneMonitor:
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weight gain,lactic acidosis, S, Monitor, Administer