1. Who is glyburide contradindicated in/caution?

contraindicated in the Type 1 and type II diabetic with few viable beta cells, those with allergies to sulfa drugs, and use caution with renal and hepatic patients?

2. How is glyburide metabolized, circulated and excreted in the body?

givel orally with an onset in 2 hr and duration of 3-4, high bound to blood proteins, metabolized in the liver, eliminated in 24 h through the pt renal system

3. What drug drug interactions can lead to hypoglycemia with glyburide?

beta blockers, alcohol, salicylates, sulfonamides, dicumarol, cloramphenicol MAOI, allopurinol, phenylbutazone

4. What is the effect of salicylates and sulfonamides of glyburide?

cause displacement from plasma proteins thus altering the pharmacokinetics leading to a huge release of insulin and hypoglycemia, and decrease urinary excretion

5. What is the effect of dicumarol, chloramphenicol and MAOI on glyburide?

they reduce the metabolism by inhibiting CYP450

6. What is the effect of allopurinol and phenylbutazone?

the decrease urinary excretion

7. What are the other adverse effects from sulfonylureas?

Gi disturbances, puritis, nausea, and anemia

8. What is the prototype Biguanide?

Metformin

9. What is the effect of metformin in general?

lowers blood glucose concentrations in type 2 diabetics without causing overt hypoglucemia, requires the presence of insulin but does not induce the release of insulin

10. What are the therapeutic effcets of metformin?

improves insulin sensitivity by increasing the action at the receptor, acts on the liver to suppress glucose production increasing the effects of insulin, reducing hepatic extraction of certain substances and opposing glucagon, enhances skeletal muscle glucose uptake, surpresses fatty acid release