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Glyburide Diabeta Pharmacology

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I cover Glyburide (Diabeta) pharmacology, adverse effects, and drug interactions.

Hey all welcome back to the real life pharmacology podcast i’m your host pharmacist eric christensen and i thank you for listening today as always go check out go snag your 31-page pdf on the top 200 drugs fantastic study guide refresher whether you’re in school or practicing out in the real world definitely a great resource to have where

I poured a little time into it and tried to highlight some of the most highly testable things as far as sport exams go as well as some of the most relevant things that actually occur in in clinical practice so go snag that for free simply for subscribing at all right so let’s get in to the drug of the day today and that is glyburide

Brand name is diabeta and this is an antidiabetic agent more specifically a sulfonylurea so if you remember back to the glyphozide episode uh this drug is is in the same class glyburide is in the same class so which can be a potential uh air which i have seen glyburide and glyphoside uh get mixed up because they do sound alike they look alike their dosing is in

The range of each other as well and they are both sophomories which stimulate that release of insulin dosing you know i’ve seen 1.25 milligrams you know up to in the neighborhood of 15 to 20 milligrams a day uh it is a drug that i i don’t see very often anymore and there there’s a few reasons for that and we’ll we’ll kind of get into it but anyway as a class as

A whole sulfonylureas have definitely gotten less and less popular due to their facts of hypoglycemia as well as weight gain so a couple negatives that are going for them but some of the newer class agents have better cardiovascular outcomes less hypoglycemia risk less weight gain and so sofaani ureas glyburide have definitely kind of fallen down the list so as

I was saying i don’t see many new starts for this medication typically the patient that i’m going to see that’s on glabyride has probably been on it for years and years and years and you know their a1c is you know okay or maybe at goal at seven or whatever the patient’s goal is so yeah why isn’t this med used i mentioned hypoglycemia risk and particularly it can

Cause really prolonged hypoglycemia and particularly in the patient population that i work with mostly and that’s geriatric patients there’s some active metabolites and things like that that can kind of hang around especially as we get older our body doesn’t clear things as quickly typically and so that can ultimately lead to more drug activity for a longer

Period of time and if we run into a hypoglycemia situation obviously that can prolong it and obviously make that an issue administration generally recommended to do with meals and consistently i have seen twice daily dosing with glyburide often times it’s just dosed once day usually if it’s going to be split up usually it’s because we’re getting to higher and

Higher doses of course there adverse effect profile so certainly the hypoglycemia the weight gain there is a rare potential for sulfur cross reactivity um you know if a patient has a true you know sulfur allergy to a sulfur antibiotic that cross reactivity risk is actually pretty low at least according to to some of the the literature there here again the odds

That you’re going to want to start a sulfoneurea and particularly glyburide in a patient is going to be uh pretty pretty low um you’re likely going to probably encounter patients that are already on it versus wanting to start it in a new patient but should the occasion arise that you need to start it definitely if you see that sulfa allergy you probably should

At least stop and think and assess what that allergy was in the past and what drug and or drugs that allergy was occurring from and then go from there with kind of your clinical assessment and judgment obviously if it wasn’t a true allergy it was you know stomach upset or whatever that’s probably not going to be an issue in starting a drug like gliburide

So i mentioned the kinetics a little bit i alluded to it so there are active metabolites this drug is on the beers list so that’s again drugs to avoid in the elderly and those active metabolites can hang around linger and and obviously cause issues as far as hypoglycemia poor renal function can also potentially play a role as it is cleared some um by the the

Kidney there as well all right so let’s take a quick break from our sponsor and we’ll wrap up with drug interactions if you’re in the market for pharmacist board certification study material like naplex bcps ambulatory care geriatrics mtm or the psychiatry certification definitely go check out store s-t-o-r-e in addition if you’re a nurse nurse

Practitioner med student or other health care professional that needs to learn about pharmacology i got lots of different resources available on amazon and audible books case studies drug interactions uh all sorts of of different stuff there so lots of goodies and and all those links are at store story all right finishing up on drug interactions

So first glyburide is partly um broken down by sip2c9 so you know a relatively you know potent two 2c9 inhibitor like fluconazole can potentially raise concentrations of glyboride another thing to think about is adding on other blood sugar lowering medications so if we’ve got if we’re adding a diabetic agent you know on to glyburide you know we’re going to

Potentially run into further lowering of that blood sugar which is expected but it may have an exacerbated effect if we’re taking a sulfonate urea like libraries already uh rifampin enzyme inducer may actually lower concentrations of a drug like glyburide um and then of course we got to think about drugs that potentially raise blood sugar too that may kind of

Counteract the effects of glyburide so classic example being corticosteroids there and then one last unique one that that i can’t say i’ve seen it come up in clinical practice but i have seen it reported anyway alcohol doing alcohol with glyburide there have been reported disulfiram reactions so that might be something to really caution your your patients on or

At least give them a little bit of heads up uh to to pay attention with with any alcohol consumption with this medication but again i think the evidence on that is kind of a little bit sketchy um but again there have been uh reports in the the literature from that as well so all right i think that’s gonna wrap it up for today if you enjoyed this podcast episode

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There questions comments for me you can reach out eric christensen farmdbcgpbbcps on linkedin or you can track me down at med education 101 at all right i’m going to sign off for today thank you so much for listening have a great rest of your day

Transcribed from video
Glyburide Diabeta Pharmacology By Eric Christianson