Our second family or category of oral antidiabetic medications are the second-generation sulfonylureas.
Now, there used to be two groups, there’s the first generation
but they’ve been replaced with the second generation.
They are more potent and safer than the first generation.
We've seen that theme in multiple medications, right?
First generation means they're the oldest ones, they were discovered first
and as we discover new generations, they're generally safer and more effective.
I've got some examples of names there for you –
glipizide and glyburide, those are second generation sulfonylureas. So, how do these work?
Well, they increase insulin release from the pancreas because they block the potassium channels.
Now, this next part is nice to know but you're probably not gonna need to know all these information
but I wanna tell you anyway – these drugs, the sulfonylureas,
increase insulin release from the pancreas – you could stop right there
and have your money’s worth. So make sure that’s what you have underlined.
Now if you wanna get more specific about the mechanism of action, it blocks the potassium channels
which allows calcium to come in and when you have the influx of calcium you have increased insulin release
but the need to know on this slide is sulfonylureas increase insulin release from the pancreas.
Beautiful! That’s what you need to know.
But here is the deal. Sulfonylureas will lower your blood sugar no matter what.
With Metformin, that’s not gonna as big a risk, you're not risking hypoglycemia.
With sulfonylurea, that is a risk so star that. It will lower whatever blood sugar your patient has,
so if their blood sugar is already normal or a little bit low, sulfonylureas are could drop that blood sugar
so on this slide what's most important for you to know,
sulfonylureas increase insulin release from the pancreas and we've got a risk of low blood sugar.
Okay, let's super charge our memory. This is study as you go method.
Don’t look at your notes and see if you can answer this question –
what difference is there in the risk of hypoglycemia for a patient taking a biguanide
like metformin versus a sulfonylurea like glipizide?
Don’t look and do your best to answer that question.
Okay, it’s the risk for hypoglycemia.
Sulfonylureas will lower blood sugar no matter what, metformin won't – it won't do that like glipizide.
Metformin regulates the blood sugar that rises after a meal but it won't directly decrease your blood sugar.
Now, we just talked about it and then we asked you a question.
If you think that’s too easy, it’s really not.
Space repetition means that you review the information quickly,
so the process of asking yourself questions even if you've just read the information
is really a good one for recall and retention.