Showing posts with label Diabetes Pills. Show all posts
Showing posts with label Diabetes Pills. Show all posts

Thiazolidinediones: A Class of Antidiabetic Medications

Thiazolidinediones: A Class of Antidiabetic Drugs

Thiazolidinediones (TZDs) are a class of oral antidiabetic medications used to treat type 2 diabetes. They work by improving insulin sensitivity in the body's tissues, making it easier for insulin to do its job of lowering blood sugar levels.
Two commonly used TZDs are:
  • Rosiglitazone.
  • Pioglitazone.

How Thiazolidinediones Work:

TZDs activate a specific type of nuclear receptor called PPAR-gamma. This activation helps to improve insulin sensitivity in the liver, muscle, and fat tissues. By increasing insulin sensitivity, TZDs can help lower blood sugar levels and reduce the need for insulin injections.

Benefits of Thiazolidinediones:

  • Improved Blood Sugar Control: TZDs can help lower blood sugar levels and reduce the risk of complications associated with diabetes, such as heart disease, stroke, and kidney disease.
  • Weight Loss: In some cases, TZDs can help with weight loss by increasing insulin sensitivity and reducing fat accumulation.
  • Reduced Inflammation: TZDs may have anti-inflammatory properties, which can help protect against heart disease and other complications of diabetes.

Potential Side Effects:

Like all medications, TZDs can have side effects. Some common side effects include:
  • Weight Gain: TZDs can cause weight gain in some people.
  • Fluid Retention: TZDs may lead to fluid retention, which can cause swelling in the legs and ankles.
  • Heart Failure: In some cases, TZDs can increase the risk of heart failure, especially in people with certain heart conditions.
  • Fractures: There is a small increased risk of bone fractures associated with TZD use.

Important Considerations:

  • Combination Therapy: TZDs are often used in combination with other antidiabetic medications, such as metformin or insulin.
  • Monitoring: Regular monitoring of blood sugar levels and kidney function is important when taking TZDs.
  • Individual Response: The effectiveness and side effects of TZDs can vary from person to person.

Weighing the Pros and Cons: The Use of Tolazamide in Modern Diabetes Care

What is tolazamide?

Tolazamide is a sulfonylurea medication used to treat type 2 diabetes. It works by stimulating the pancreas to produce more insulin.

Historical Context and Current Usage:

  • Development: Tolazamide was introduced in the 1960s as one of the early oral antidiabetic agents.
  • Shift in treatment: In recent years, there has been a shift toward newer medications with improved safety profiles and efficacy, such as metformin, sulfonylureas of newer generations, and newer classes of diabetes medications.
  • Limited use: Due to these advancements, tolazamide is less commonly prescribed today compared to its peak usage. However, it may still be used in certain situations or in combination with other medications.

Comparison to Other Sulfonylureas:

  • Second-generation sulfonylurea: Tolazamide is a second-generation sulfonylurea, which means it has a longer duration of action compared to first-generation agents.
  • Comparison to newer agents: While tolazamide can be effective in controlling blood sugar levels, newer sulfonylureas like glimepiride and glipizide often have a lower risk of hypoglycemia and may be preferred in certain situations.

Considerations for Use:

  • Individual needs: The decision to use tolazamide should be based on the individual patient's needs, medical history, and response to other medications.
  • Risk of hypoglycemia: As with all sulfonylureas, tolazamide can increase the risk of hypoglycemia. Patients should be educated on the signs and symptoms of hypoglycemia and have a plan in place to treat it.
  • Combination therapy: Tolazamide may be used in combination with other diabetes medications, such as metformin or insulin, to achieve better blood sugar control.

Alternative Medications:

  • Metformin: Metformin is often considered the first-line treatment for type 2 diabetes due to its effectiveness and relatively few side effects.
  • Newer sulfonylureas: Glimepiride and glipizide are newer sulfonylureas that may have a lower risk of hypoglycemia compared to tolazamide.
  • Other classes of diabetes medications: There are many other classes of diabetes medications available, including DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT2 inhibitors, which may be more suitable for certain patients.

Conclusion:

It's important to consult with a healthcare provider to discuss the potential benefits and risks of tolazamide and to determine if it is the right medication for you. They can help you weigh the options and choose the most appropriate treatment plan.

Chlorpropamide: Causing a sharp drop in blood sugar, especially in the elderly who suffer from a lack of kidney function

Chlorpropamide:

General Information:

  • Chlorpropamide is an oral medication belonging to the sulfonylurea class.
  • It's used to treat type 2 diabetes by stimulating the pancreas to release more insulin.
  • It has a long-acting effect, lasting for many hours.

Risks and Considerations:

- Hypoglycemia (low blood sugar):

This is the main risk associated with chlorpropamide, especially in elderly patients with reduced kidney function, as mentioned before.

- Other side effects:

Nausea, vomiting, diarrhea, skin rash, and allergic reactions are less common but still possible.

- Contraindications:

Chlorpropamide shouldn't be used in people with type 1 diabetes, diabetic ketoacidosis, severe liver disease, or hypersensitivity to sulfonylureas.

Alternatives:

If you're concerned about the risks of chlorpropamide, other types of medications for type 2 diabetes are available, such as shorter-acting sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists, and insulin.

Repaglinide. Natiglinide. Mitiglinide.. new drugs taken by mouth in the form of tablets in patients with type II diabetes

Repaglinide. Natiglinide. Mitiglinide


Is new drugs taken by mouth in the form of tablets in patients with type II diabetes.


Advantage of these drugs quickly absorbed from the gastrointestinal tract when taken by mouth and therefore the rapid therapeutic effect. Therefore it needed to be addressed immediately before each meal. The estimated time required to obtain the highest concentration of these drugs in the blood by about 55 minutes. And these drugs is metabolized quickly by the liver and an estimated half-life of about one hour. And duration short therapeutic Mfolhm where between 3-4 hours and therefore these drugs are less likely to a sharp decline in the patient's blood sugar.

How do these drugs work?

These drugs are similar to the mechanism of action drugs sulfonylureas where to alert the secretion of the hormone insulin from the beta cells in the pancreas, but weaker than the sulfonylureas drugs.

Therapeutic dose:

Given drugs Almkulaitinad   In the form of tablets for oral dose ranging between 0.25-4 mg (maximum 16 mg   Per day). And is usually taken just before eating to reduce   The rise in blood glucose after a meal in patients with type II diabetes who can not control the level of sugar have well through sports nutrition.And can cause these drugs sharp fall in blood glucose when you delay a meal, or not taken, or they do not contain a sufficient amount of sugars.

And can   Utilization   Almkulaitinad drugs individually or with metformin. These compounds differ in chemical form for drugs sulfonylureas not contain sulfur and therefore can be used as an alternative to drugs sulfonylureas in patients with type II diabetes who are allergic to congenital sulfonylureas. These may be good medicine in patients who may be at risk for kidney problems.

Possible side effects:

  • Symptoms include side drugs Almkulaitinad diarrhea and headaches.
  • Ribakulainad drug may have a degree of gravity on the heart, such as sulfonylureas drugs, while new medicines, like Natakulainad may be less dangerous to the heart.
  • These drugs should be used with caution in patients who suffer from poor liver function.
  • May accompany the use of these drugs increased slightly in the patient's weight, but less than that resulting from the drugs sulfonylureas.

Side effects of the drug Rosiglitasone.. Shortage in the amount of high-density lipoprotein cholesterol, which provides protection from arterial disease such as coronary artery thrombosis

I have already mentioned to you some of the side effects of the drug Zzouzajlettazon is a grain types of stimuli insulin in type II diabetes has been off the study, known as Accord "Accord" And performed on type II diabetics who suffer from a high degree of risk to the risk of heart complications and blood vessels. The Rzuijlettazon was one of the drugs used in this study. The study was stopped for the emergence of several deaths in patients   Participants in this study and the other side effects of the drug rosiglitazone rosiglitasone They lack in quantity of high-density cholesterol HDL-C It, which provides protection from arterial disease such as coronary artery thrombosis. In addition, that rosiglitazone reserves amount Of water in the body and prevents use it just in case there was a lack of heart muscle (congestive heart failure) CHF . Based on the above I would advise type II diabetics not to use this property for good.

Xinatad Exinatide.. For patients with Type II diabetes. Extract from the material available in the saliva of wild lizards

This drug works the same mechanism of drug Alfeldakulaibtin an extract from the material available in the saliva of wild-type lizards Gila recently was approved by the Food and Drug Administration is currently available in the U.S. only.
A drug used for patients with type II diabetes in addition to their usual medication by injection under the skin before eating meals morning and evening.
The producers hope to prove this drug merit conferred be dealt with treatment of patients individually without having to deal with other medicines for diabetes with him.

Vildagliptin.. Increased secretion of insulin from the pancreas. Improve the level of sugar in the blood in patients with type II diabetes

No luck scientists that the secretion of insulin in the blood increases when dealing with human sugar through the mouth more than is the case when injecting liquid sugar intravenously. This led the researchers to the discovery of the hormone secreted by intestinal cells leads to increased secretion of insulin from the pancreas, called hormone Ankeratin (incretin). It has been observed that patients with type II diabetes have as a deficit in the secretion of the hormone. 
The drug Feldakulaibtin of new drugs that can be used in patients with type II diabetes in addition to their usual medication. This drug is currently undergoing clinical trials on volunteers of diabetics in several regions of the world in preparation for registration by the Food and Drug Administration (FDA ). 
And this drug is rapidly absorbed from the gut when taken by mouth. Food affects slightly the speed of absorption. And combines with blood proteins to a very few, and is converted by the liver into compounds is effectively disposed of the body through the urine. 
Mechanism of drug action:
Characterized drug Feldakulaibtin improving the level of sugar in the blood in patients with type II diabetes by increasing the secretion of hormone Ankeratin and inhibiting enzymes that lead to broken down and lack of effectiveness.
Therapeutic dose:
Given drug Feldakulaibtin the form of tablets for oral in patients with type II diabetes, either alone or with medicines for diabetes such as Alambtforman, and set sulfonylureas, Altheozouliden debts or insulin in the event that the patient to adjust the level of blood sugar through diet, sports or using a single drug.The recommended dose ranging between 50-100 mg per day. And if required the use of this drug at a dose of 100 mg can be taken once a day or give it in the form of two doses the amount of 50 mg each morning and evening. There is no need for dose adjustment in patients with impaired liver function and kidney, but not recommended to use this medication if the individual is suffering from kidney disease in its final stages.
Possible side effects:
Side effects are common due to the use of this medicine:
* Headache, nausea
* Debility
* Constipation
* Pain in the joints

Alpha-glucosidase inhibitors. Acarbose

Monosaccharides such as glucose and dextrose (fructose) is all that can transit through the mucous membrane of the intestines to the blood circulation. The contents of the food polysaccharides (starch) and bilateral sugars (sucrose) it is necessary to be broken within the intestine into mono sugars (glucose mainly) before it is absorbed from the intestine. Usually food is digested in a relatively small part of the intestine which is the upper part of the small intestine by enzymes present in the intestine known as "alpha Gelokozaadez" and you break down polysaccharides and converted to glucose, which is rapidly absorbed from the intestine into the circulation. This leads to a rapid rise in blood glucose after a meal directly, as the resulting stress on the pancreas. Without these enzymes, these sugars can not be absorbed from the intestine and are brought out through the feces.
How do these drugs work?
Lead Alokarboz done through competition with sugars in union with enzymes the "alpha Gelokozaadez". The competitiveness of Okarboz union with enzymes alpha Gelokozaadez equivalent to 1000 times greater than the sugars. And by Alokarboz union with enzymes the "alpha Gelokozaadez", those enzymes lose their ability to break down sugars and result in slow digestion of starches and sugars in bilateral upper part of the small intestine and is absorbed gradually when offered in the intestine through twelve(duodenum ), And fasting intestine (Jejunum ), And ileum intestine (ileum ). This leads to slow in process Skralgelokoz absorption from the intestine and thus limits the dramatic rise in glucose in the blood after eating a meal. This in turn   Reduces stress on the pancreas where insulin is low in the blood after a meal and this might be useful, as the rise in the rate of insulin after meals may be accompanied by an increase in the risk of heart disease.
It should be noted that Alokarboz designed to slow down the absorption of glucose from the intestine and not to prevent its absorption.
Medical Uses:
Has been recognized by the Department of Nutrition and Drug Administration (FDA ) Use Alokarboz in patients with type II diabetes with metformin, Oaduah   Sulfonylureas, or insulin. And drug Alokarboz alone does not cause a sharp drop in blood sugar to low rates only if used with other antihypertensive drugs sugar. To meet any shortage of blood sugar in this case, it must be accessible to the patient source of glucose (glucose tablets) to be used when necessary. It does not help to use regular sugar in this case or starchy food because Alokarboz prevents digested and converted into mono sugars and thus prevents absorption.
The drug such as metformin can be useful in cases of obese patients with type II diabetes. Also noted that the drug Alokarboz reduces hemoglobin A1C When used alone or in combination with other antihypertensive drugs sugar.
The recommended dose of this medication is 25-100 mg, taken immediately before a meal.
Possible side effects:
That less than 2% of the drug Alakarboz is absorbed from the intestine into the circulation and the rest is excreted with feces, so the drug is safe on the circulatory system. Since these drugs prevent cracking polysaccharides and converted to glucose   It leads to the accumulation of these sugars in the intestine and decomposition by bacteria found in the colon and the resulting   Occurrence of abdominal pain, diarrhea, bloating and gas. This unfortunately is uncomfortable for many patients and may lead to stop using the treatment.
As the severity of those side effects depend on the therapeutic dose, it is usually advised to use small doses of the drug initially Alokarboz can be increased gradually as needed.

Glipizide.. Less likely to cause a sharp drop in blood sugar Aljlaepjurajd

Algelebeizaid drug absorbed well from the intestine when given by mouth. For greater rate to reduce the level of blood sugar after a meal it is necessary to take this medicine before eating breakfast thirty minutes where that hinders the absorption of food intestinal Algelebeizaid.
And about 90% of the drug is metabolized in the liver to compounds is effective, and 10% of the drug is ejected through the urine is variable. It has a shorter half-life (2-4 hours) compared with drugs sulfonylureas powerful second-generation effect. And because of the short half-life, this drug are less likely to cause a sharp drop in sugar blood from Aljlaepjurajd. And duration of effect in the body 10-16 hours.
Therapeutic dose: 
Advised to use an initial dose and one $ 5 - 15 mg per day. And when you need to give higher doses per day, it should be divided and given before eating. The total daily dose advised by the manufacturer of the drug 40 mg per day, although some studies have indicated that the reduction   Maximum therapeutic effect of this drug can be achieved using a dose of 15-20 mg.
Not recommended using Algelebeizaid in patients who suffer from poor liver function or failure in kidney function and who may be vulnerable to a sharp drop in blood sugar.

Glimperide.. Well absorbed from the intestine and is metabolized by the liver into ineffective compounds

Gelimbraad drug absorbed well from the intestine, and is metabolized by the liver into ineffective compounds are taken out through the urine. The half-life of the drug is 5-9 hours and the duration of effect in the body 12-24 hours.  
Therapeutic dose:
Usually given   Drug Algelimbraad dosage form once a day, either alone or in combination with insulin for diabetics who can not control their sugar levels through diet and sport. This medication leads to a decrease in the level of blood sugar lower dose than any other compound of drugs sulfonylureas, where studies have shown that only 1 mg of the drug has the ability to reduce the level of sugar in the blood.
The maximum dose recommended daily equivalent to 8 mg. In addition to the alert insulin secretion from beta cells, characterized by the property Algelimbraad slight reduction of insulin resistance and thus may be less inclined to cause a sharp drop in blood sugar than other drugs sulfonylureas. And also considered safer in people who suffer from a severe lack of kidney function and who have their creatinine level is high. Usually not recommended to use drugs other sulfonylureas in patients who have their creatinine levels high. Also, this drug does not prevent the natural process of extroversion of blood vessels does not affect the coronary arteries. These side effects may occur with other sulfonylureas drugs albeit rarely.

Metformin.. No effect on the beta cells in the pancreas because its mechanism of action does not depend on the secretion of insulin from the pancreas

Given Akaralmitforman form oral tablets in patients with type II diabetes. The drug is absorbed well from the intestine. The drug combines with blood proteins as it is not metabolized in the liver and is ejected is variable in the urine. The half-life Of the drug ranges between 1.5-3 hours.
How do these drugs work?
Metformin works to maintain a constant level of glucose in the blood by increasing the sensitivity of liver, muscle, and fat tissue to insulin and this leads to:
·     Reducing the amount of glucose secreted by the liver and obstructing the transformation of glycogen stored in the liver to glucose.
·     Increased glucose entry and utilization in muscle and adipose tissue (and thus reduces insulin resistance).
·     Limit the ability of the intestine to absorb glucose from the meal.
Metformin is characterized for drugs sulfonylureas and insulin thus:
·   No effect on the beta cells in the pancreas as the mechanism of action does not depend on the secretion of insulin from the pancreas, and as a result, drug metformin does not cause   A rise in the level of insulin in the blood and thus Does not lead to a sharp drop in blood sugar when used alone   As it happens with drugs sulfonylureas or insulin.
·   These drugs do not cause an increase in the weight of patients, as observed when using drugs sulfonylureas or insulin. This may be due to the fact that metformin does not alert the appetite to eat when the patient. And therefore the drug metformin   Is considered good medicine for obese patients with type II diabetes.
It should be noted that in the event of the use of metformin with sulfonylureas drugs or with insulin may happen sharp drop in blood sugar, as well as an increase in the weight of the patient.
·   Another benefit of metformin ability to reduce the level of fat in the blood, especially type low-density(LDL ) Known Bdharrh body, especially for diabetics. In a comparative study found that metformin achieved the lowest death rate (8%) compared to insulin (28%), and sulfonylureas (16%), and debt Althiazouliden (14%).
Medical Uses
Described Akaralmitforman older and younger patients with type II diabetes and especially obese people, because of insulin resistance. And this drug can be used either alone or in combination with other antihypertensive drugs in the case of sugar the inability of a single drug   To reduce the level   Sugar in the blood. Metformin can be used also to prevent diabetes in people at risk for this disease, as well as for the treatment of polycystic ovaries   Polycystic ovaries .
Therapeutic dose
Metformin is usually taken twice a day with breakfast and dinner and the doctor dosage according to the needs of each patient. In adult patients are usually start with a dose of 500 mg taken twice daily   Or 850 mg once daily. The dose is increased gradually by 500 mg per week or 850 mg every two weeks if the patient holds it until it reaches the level of sugar in the blood to   Limit. The highest dose of this medication in the 2550 mg given day an average of three doses. If I give long-acting tablets metformin Vtkon initial dose of 500 mg per day taken with the evening meal in the evening. The dosage may be increased by 500 mg per week up to a maximum of 2000 mg once or twice a day. Metformin should be taken with a meal.
In children aged 10-16 years, so the initial dose of 500 mg twice a day, and can be increased by 500 mg per week up to a maximum of 2000 mg.

Possible side effects of metformin.. The appetite, vomiting, nausea, stomach upset and diarrhea

**   Side effects of concentrated metformin mainly on the digestive tract. And include loss of appetite for eating, vomiting, nausea, and upset stomach, and diarrhea. These symptoms occur in about 20% of patients in a dose-dependent and treatment and often temporary disappear with long-lasting in the use of the medication. Metformin dealt with eating helps minimize those side effects. The treatment is stopped in 3-5% of patients because of diarrhea.
**   The patient's sense of a metallic taste in the mouth because of the taste of metformin.
** Use of metformin may cause long hampered the absorption of vitamin B12 from the intestine, resulting in a lack of this vitamin.
Therefore, the manufacturer of this drug recommends periodic test work to determine the rate of vitamin B12 in the blood and giving injections of this vitamin when needed. 
** Of the serious side effects of metformin a milky poisoning
(Lactic acidosis ) As a result of the accumulation of lactic acid in the blood. This situation is almost very rare, where he spoke in person and one out of every 30,000 patients and cause death in 50% of cases.Symptoms include the accumulation of lactic acid: general weakness, and respiratory problems, and disorder in heart Nbzat, and abnormal pain in the muscles, and stomach pain, headache, and feeling cold.In this case, it must enter the patient to the hospital and give doses of sodium Beckernont intravenously.
The patients most at risk of lactic poisoning include those who suffer from a deficiency in kidney function or liver, and those who suffer from congestive heart failure Congestive heart failure , Serious and acute diseases, and drought.
* Metformin should not be given to pregnant women, and patients who suffer from an allergy to this type of medication, and alcoholics, and patients who have the keto poisoning. As should not use this medication if the patient suffers from imagines in heart function, kidney, and liver due to increased risk of lactic acid resulting from the accumulation of metformin because those members are very sensitive to lack of oxygen.

Glyburide (Glibenclamide).. Effectiveness too weak to reduce the level of sugar in the blood

Glyburide drug absorbed well when administered orally but unimpaired absorbed the existence food in the stomach And therefore can be taken with a meal. The advantage of this drug that in spite of his short half-life (less than 3 hours), but the effect lasts for a period of twenty-four hours after a single dose in the morning.
It is metabolized in the liver to have effective compounds too weak to reduce the level of sugar in the blood. And is directed by products of the metabolism of this drug for a way urine and bile.
Therapeutic dose:
And there in the form of tablets weighing 1.25 mg, 1.5 mg, 2.5 mg, 3 mg, 5 mg.
Usually given Aljlaepjurajd in initially at a dose of 2.5 mg per day or less. The average dose of between 5-10 mg per day, given in the form of a single dose in the morning. Not recommended to use higher doses of 20 mg per day.
This drug does not result in the detention of the fluids in the body, as happens with but Alklorbrupamid on the contrary cause lucrative Paul albeit slightly.
Not recommended to use this drug in patients with impairment of liver function or patients who suffer from a deficiency in kidney function.

Acetohexamide.. It is metabolized rapidly in the liver into effective compounds are brought out in the urine

Asatohecsamed drug absorbed well from the intestine when   Give   Oral   And is rapidly metabolized in the liver into effective compounds are brought out   In the urine and therefore should use this drug with caution in patients who suffer from a deficiency in kidney function. The effect of this medicine average between Altolobiotamed and Alklorbrupamid ranging between 10-16 hours. The half-life of the drug and its metabolites in the range of 6-8 hours. The effect is similar to a drug terms Altolbyautamad increased diuresis. And has the same side effects of drugs other sulfonylureas.
Therapeutic dose:
There in the form of tablets weighing 250 mg and 500 mg. Therapeutic dose range for Alasatohecsamed drug between 0.25-1.5 grams per day, taken once or twice a day.

Tolbutamide.. Absorbed from the intestine is excellent and is metabolized quickly by the liver

The drug Altolbyautamad of the oldest drugs sulfonylureas are still the most commonly used   To reduce the level of blood sugar in patients with type II diabetes.
When administered orally, it is absorbed from the intestine very well and at the same time is metabolized quickly by the liver. All ineffective Mstqlabath, and have no effect lowers blood sugar and are brought out through the urine. The effect of this drug is relatively short (6-8 hours), and the half-life Half-life) ) Has within 4-5 hours. Due to the metabolism of this drug fully it is considered the safest drug of sulfonylureas drugs in elderly patients  Type II diabetes and those who suffer at the same time
Deficiencies in kidney function. And unite this property strongly with blood proteins and therefore can react with other medications (such as Sulaiceli and sulfa compounds) that compete with link Altolbyautamad centers with protein. 
Therapeutic dose:
There in the form of tablets weighing 250 mg and 500 mg.
Preferably use Altolbyautamad drug doses (eg 500 mg before each meal and before going to sleep).Some patients may need to only one pill or TWO day.
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