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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 :)