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glyburide

glyburide

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Published by: api-3797941 on Oct 17, 2008
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glyburide
(glye' byoor ide)
Albert Glyburide (CAN), DiaBeta, Euglucon (CAN), Gen-Glybe (CAN),
Glibenclamide, Glynase PresTab, Micronase
Pregnancy Category B
Drug class
Antidiabetic
Sulfonylurea
Therapeutic actions

Stimulates insulin release from functioning beta cells in the pancreas; may improve
binding between insulin and insulin receptors or increase the number of insulin receptors;
more potent in effect than first-generation sulfonylureas.

Indications
\u2022
Adjunct to diet to lower blood glucose with type 2 (non\u2013insulin-dependent)
diabetes mellitus
\u2022
Adjunct to metformin when adequate results are not achieved with either drug
alone
\u2022

Adjunct to insulin therapy in the stabilization of certain cases of type 2 diabetes,
reducing the insulin requirement, and decreasing the chance of hypoglycemic
reactions

Contraindications and cautions
\u2022

Contraindicated with allergy to sulfonylureas; diabetes with ketoacidosis, sole
therapy of type 1 (insulin-dependent) diabetes or diabetes complicated by
pregnancy, serious hepatic or renal impairment, uremia; diabetes complicated by
fever, severe infections, severe trauma, major surgery, ketosis, acidosis, coma
(insulin is contraindicated); thyroid or endocrine impairment, glycosuria,
hyperglycemia associated with primary renal disease; labor and delivery (if
glyburide is used during pregnancy, discontinue drug at least 1 mo before
delivery).

\u2022
Use cautiously with pregnancy, lactation.
Available forms
Tablets\u20141.25, 1.5, 2.5, 3, 4.5, 5, 6 mg
Dosages
ADULTS
\u2022
Initial therapy: 2.5\u20135 mg PO with breakfast (DiaBeta, Micronase); 1.5\u20133 mg/day
PO (Glynase).
\u2022
Maintenance therapy: 1.25\u201320 mg/day PO given as a single dose or in divided
doses. Increase in increments of no more than 2.5 mg at weekly intervals based on
patient's blood glucose response (DiaBeta, Micronase); 0.75\u201312 mg/day PO
(Glynase).
PEDIATRIC PATIENTS
Safety and efficacy not established.
GERIATRIC PATIENTS

Geriatric patients tend to be more sensitive to the drug; start with initial dose of
1.25 mg/day PO (DiaBeta, Micronase) 0.75 mg/day PO (Glynase). Monitor for 24 hr, and
gradually increase dose after at least 1 wk as needed.

Pharmacokinetics
Route
Onset
Duration
Oral,
micronized
1 hr
12\u201324 hr
Oral,
nonmicronized
2\u20134 hr
12\u201324 hr

Metabolism: Hepatic; T1/2: 4 hr
Distribution: Crosses placenta; enters breast milk
Excretion: Bile and urine

Adverse effects
\u2022
CNS: Drowsiness, tinnitus, fatigue, asthenia, nervousness, tremor, insomnia
\u2022
CV: Increased risk of CV mortality
\u2022
Endocrine:Hypoglycemia
\u2022
GI: Anorexia, nausea,vomit ing, epigastric discomfort, heartburn, diarrhea
\u2022
Hematologic: Leukopenia, thrombocytopenia, anemia
\u2022
Hypersensitivity: Allergic skin reactions, eczema, pruritus, erythema, urticaria,
photosensitivity, fever, eosinophilia, jaundice
Interactions
Drug-drug
\u2022
Increased risk of hypoglycemia with sulfonamides, chloramphenicol,
oxyphenbutazone, phenylbutazone, salicylates, clofibrate
\u2022
Decreased effectiveness of glyburide and diazoxide if taken concurrently
\u2022
Increased risk of hyperglycemia with rifampin, thiazides
\u2022
Risk of hypoglycemia and hyperglycemia with ethanol; "disulfiram reaction" has
been reported
Drug-alternative therapy
\u2022
Increased risk of hypoglycemia if taken with juniper berries, ginseng, garlic,
fenugreek, coriander, dandelion root, celery
Nursing considerations
CLINICAL ALERT!
Name confusion has occurred between DiaBeta (glyburide) and Zebeta
(bisoprolol); use caution.
Assessment

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