When to start sulfonylureas
How do Sulfonylureas work? Diabetes Management
Anti diabetics. In today's video we are looking at sulfonylureas -a long twisted
name but in essence they help lower our blood sugar and we're going to talk
about how they do that right after this.
Welcome back my name is Tammy and this is NurseMinder and on this channel we
do everything nursing so if you're new here consider subscribing below so that
you get the next video when its released. Today we are talking about sulfonylureas,
well that's a tongue twister! We're going to dissect that word for you. It's a
classification of anti-diabetic drugs. Now before we get started be sure to
comment, share and link in the description box below. I would love to hear
from you. First we're going to start with a review
of the pancreas. The pancreas is an interesting organ in that it has two
different cell types that are of interest in terms of digestion of food.
The first is the acinar cells and they have an exocrine function
in that they produce digestive enzymes to help break down our food. What we're
interested in, in this medication is the beta cells. Now the beta cells are where
our insulin is produced which is an endocrine function. When I've got lots of
sugar floating along in my bloodstream, my pancreas is signaled, the pancreas
ramps up production of those beta cells and gives my body more insulin to move
this glucose from the blood system into the cells. Now with some patients, type 1
and type 2 diabetes, these beta cells are not functioning at their optimum. We're
going to help those beta cells do their job by taking a medication called
sulfonylureas. Now we're focusing on second-generation sulfonylureas
because they're most commonly used in practice. I do have a list of first
generation drugs here and you'll notice that there is some similarities in the
naming of the drugs and the use IDE at the end of our first generation. It is also
in our second generation, and so our first generate
are actually used less frequently nowadays because there have been found
to be less effective in managing glucose but they've also been identified an
increasing cardiovascular risk. So I'm gonna focus just on second gen because
that's most likely what you'll see in practice. so glyburide, glimerperide,
glipizide. We also notice that they all start with a GLI or a GLY, so
kind of glucose, glycogen those kind of clues that this drug might be used for
sugar, and IDE is the ending that we're looking for to identify it as a
sulfonylurea. Now let's get started with looking at how they work. They increase
insulin production so that means these are given to patients who have a
functioning pancreas, so both patients living with type 1 or type 2 diabetes
you may find them on this medication, if they have a functioning pancreas. So how
does this work? Sulfonylurea, this medication comes down into the beta
cells and says so we need to improve the function of your work. So we need more
insulin so we're going to ramp up production of insulin, so that insulin
will then be secreted from the beta cells into the pancreatic duct traveling
into the intestine so that it can be utilized in the body. That's one way it
works. The other way it works - there's a second one. So it kind of needs
sulfonylurea to start so sulfonylurea is going to bind here on the cell - it's going to
enhance the number of insulin at the party, so insulin is filling up that
receptor site so that glucose can then enter into the cell. Now some people use
the acronyms, or the the visual of a cell phone.
Instead of sulfony they will say cell phone, and that visual helps them think well
cell phones helped me be very productive cell phones also aid in connecting
things so if I think of a cell phone and how it works for me in a daily life, I
might be able to remember that sulfonylureas help connect. So we're
sulfonylurea binds, increases insulin affinity, opens up those channels for
glucose to enter the cell it also is increasing productivity. I couldn't work
without my cell phone and so I mean even this video is being made by my cell
phone, so increasing productivity and the beta cells to produce insulin. Now the
best time idea to take your second generation sulfonylurea, you're on
glyburide - is in the morning because we want to increase insulin production as
glucose is rising in the bloodstream and that rises with food. So one way to help
remember is the I in IDE. It usually takes 30 minutes to 1 hour for this to
start to work. So you want to make sure you're giving this before you eat. Now
let's talk about side effects. When we understand how the drug works then we
can predict more accurately what we should be watching for if we take the
drug incorrectly or if we are prescribed too much or maybe we're not eating when we
take this drug. Ok so we know that this is to increase insulin production to help
get that glucose out of the blood into the cells, decreasing how much glucose is
circulation. So if the goal is to decrease glucose our side effects, signs
and symptoms of side effects are going to be related to this, so anything to do
with hypoglycemia. So confusion, maybe we've got some headaches, and blurred
vision, we're not quite feeling ourselves. Hypoglycemia. We may have
anorexia, if we are taking our medications and then not eating we may
notice that there's some weight loss, and of course anything you put into our
stomach and always cause us to feel nauseous, upset, diarrhea, vomiting,
constipation - any of those who could be involved. In addition it may cause us to
have a little bit of gas and some discomfort. Now with all the medications
you always have to consider what other medications your patient is on so this
is often used in combination with insulin or with other oral hypoglycemics
and so we'll be wanting to monitor that sugar to make sure we're getting
therapeutic ranges for our patient. With sugar levels in the bloodstream some of
the things that can increase that would be stress, illness, injury, and so as a
result if we're underneath a stressful situation like maybe an exam at school
or a big life change our sugar levels are going to rise and so the may need to
adjust our dose of medication but do that with the help of your healthcare
provider. So as a quick summary sulfonylureas are a second-generation
anti-diabetic oral medication to help manage your glucose levels. If you use
the thought of a cell phone, cell-phone-ylurea; cell phones increased productivity - so
production of our beta cells for insulin, cell phones also help improve binding
and connections, so that's at that cell where it's bringing all that different
insulin to help get glucose into the cell. Until next time make it a great day
and don't forget to subscribe and put a comment below let me know if this has
been helpful :)
