Tablet hypoglycemic agents
These drugs are used to treat type II diabetes.For their application there are contraindications, such as acute complications of diabetes, severe liver and kidney with a violation of their function, pregnancy, childbirth, lactation, blood diseases, acute inflammatory diseases, vascular complications of diabetes, surgery, a progressive decreasebody weight.Tablet hypoglycemic drugs are divided on the basis of their impact on the development stage of diabetes.These stages are: an ejection failure of insulin in the blood, body tissue resistance to insulin, increased glucose production in the liver, toxic effects of excess amounts of glucose.
Based on this there are three groups of drugs.
1. Medications that increase the release of insulin into the blood.They stimulate the production and release of insulin β -cells of the pancreas.These medications include sulfonylurea drugs and nesulfanilmochevinnye sekretogogi (glinides).
2. Drugs that reduce the body's resistance to insulin.They reduce hepatic glu
3. Drugs that inhibit the absorption of carbohydrates in the gastrointestinal tract.This group includes the well-glucosidase inhibitors.
4. Preparations sulfonylurea.These include glibenclamide, gliclazide, glimepiride, glipizide, gliquidone.Drugs in this group act on β -cells of the pancreas, causing the release of insulin in their blood stream.With adequate treatment drugs sulfonylurea sensitivity β -cells to increased glucose level increases.This insulin production will be closer to the physiological, t. E. That of a healthy person.Unmotivated receiving excessive doses of drugs, as well as chronic disorders of diets lead to constant over-stimulation β -cells of the pancreas, which in turn causes an increase tissue resistance to insulin, raising blood sugar levels.Side effects from taking sulfonylurea drugs are very diverse.There may be a condition of excessive reduction of blood sugar that occurs when receiving insufficient amounts of food, the presence of renal impairment, accumulation of the drug in the body, when taking long-acting drugs, as well as in the absence of weight loss on the background diet.Possible side effects from the blood.These complications occur in very rare cases.There may be allergic reactions.In a rare variant of allergies may experience jaundice development.
glibenclamide. This drug is used most often.The effect appears after 40 minutes after administration, reaching its maximum after 2 h. The effect lasts for 10-12 hours. The product is fully processed by the liver and 50% is excreted in the urine, the other 50% are excreted in the bile.Treatment begins with 2.5 mg glibenclamide destination for 30 minutes before a meal.If there is no effect for several days, the dose was gradually increased.If no effect after a single dose of 5 mg of glibenclamide must take medication at a dose of 2.5 mg for 30 minutes before supper.If the dosage is more than 15 mg, a further increase in dose will not lead to increased effect.
Gliclazide. starts to act after 30 minutes after administration.Peak efficiency is observed after 2-3 hours. Duration 12 hours. The product is fully processed by the liver.Displays using kidneys.At the start of treatment the daily dose is 40-80 mg.The maximum possible dose is 320 mg.The daily dose is divided into 2 doses.Gliclazide reduces blood glucose levels, as well as a positive effect on blood flow in small vessels.
Glipizide takes effect after 10-30 minutes, the efficiency of the peak observed at 1.5 hours. The effect lasts for 8-10 hours. The product is fully processed by the liver, is derived through the kidneys.The probability of excessive reduction of blood sugar in the background of his admission is minimal.The initial dose is 2,5-5 mg, the maximum daily and should not exceed 20 mg.The daily dose is divided into 2-4 reception.
gliquidone. This drug can be used in the presence of renal disease, since it appears at 95% through the intestines.The effect after 40 minutes after taking the drug, reaching a peak after 2 hours Duration -.. 6-8 hours minimum dose is 30 mg with a maximum of 180 mg.The drug is taken 2-3 times a day, depending on the dose.
Glimepiride stimulates β -cells of the pancreas, increasing the release of insulin in the blood and reduces the resistance of tissues to the hormone.The drug can be taken one time a day.The initial dose is typically 1 mg, the daily maximum - 8 mg.
Nesulfanilmochevinnye sekretagogi (glinides) are a new group of tablets saharoponizhayuschih drugs.These drugs stimulate the release of insulin by the pancreas.There are a number of indications for use of these drugs: new-onset type II diabetes in combination with the signs of insufficient insulin production;elderly age;intolerance of other tablets sugar-reducing drugs.Widespread drugs such as repaglinide and nategli-NID.Side effects are similar to the side effects of using drugs sulfonylurea.
Biguanides. Of this group of most widely used drugs metformin.It reduces the intensity of glucose production in the liver.Under his influence, increases the sensitivity of tissues to insulin.In addition, the drug has a softly pronounced effect of reducing appetite.While taking this drug slows the absorption of carbohydrates in the intestines, there is a decrease in blood cholesterol.Basically metformin is used in the type II diabetes with obesity or elevated blood fat.In some cases, there is a number of side effects such as bloating, nausea, diarrhea, discomfort in the stomach, loss of appetite, and metallic taste in the mouth.Digestive disorders are the result of slowing glucose absorption in the intestine, which leads to increased fermentation processes.Sometimes develop allergic reactions.There are several contraindications to the use of metformin.These include the condition of hypoxia (lack of oxygen saturation of body tissues), the liver, kidneys, lungs, heart failure, aged age.metformin treatment requires monitoring of hemoglobin levels 1 time in 6 months.
Thiazolidinediones or sensitayzery.This new group tablet saharoponizhayuschih drugs.These drugs eliminate the body's resistance to insulin, which is the main cause of type II diabetes.Additionally, sensitayzery help reduce blood fat level.Thus, simultaneously with the treatment of diabetes is carried out disease prevention of the cardiovascular system.Two of the group of drugs most commonly used are: rosiglitazone and pioglitazone.The use of these drugs does not cause excessive loss of blood sugar levels.glitazones treatment requires monitoring of blood tests 1 once a year.Perhaps the development of the following side effects: abnormal liver function, swelling, weight gain.There are a number of indications for the use of drugs of this group: newly diagnosed diabetes mellitus type II with the presence of signs of tissue insulin resistance, lack of effect of diet treatment, no effect from taking sulfonylurea agents and biguanide, intolerance of other tablets sugar-reducing drugs.Contraindications: changes in the blood, heart failure, III, IV degree.
a-glucosidase inhibitors.glyukobay (acarbose), the drug is used mainly.In the intestine, there is no absorption of complex carbohydrates.Initially, they are broken down into simpler compounds that can be absorbed in the intestine.Cleavage occurs under the influence of special substances - a-glycosidases.Glyukobay blocks a-glucosidase, which leads to decreased absorption of carbohydrates in the intestine.Blocking is reversible.Influenced glyukobaya happens pronounced rise in blood sugar after a meal.The effect is achieved if the tablets are not chewed and taken just before meals or during meals.Perhaps the development of the following side effects: bloating, diarrhea, allergic reactions.Digestive disorders are the result of the fact that not digest carbohydrates enter the large intestine where the processed bacterial flora, which is accompanied by considerable flatulence.Contraindications: intestinal malabsorption disorders, acute and chronic hepatitis, ulcers, and narrowing of the crack of the gastrointestinal tract.Do not use the drug during pregnancy, lactation, as well as persons under 18 years of age.