Welcome back to the real-life pharmacology podcast.

Today we're going to cover an anti-diabetic agent called the sulfonyereas.

And classic examples of medications in this class is glypozyde, which is brand name glucatrol,

glibiride, which is dibeta, glomepiride, which is amaryl, and chloropropomide, which is an older, older,

sulfonyurea that, honestly, I have not seen used in practice in a long, long time.

There is one clinical quirk kind of with chloroporomide, which I'll talk about in the adverse reactions segment

of the podcast today. So how do these drugs work in managing diabetes? If you remember diabetes,

we're generally going to have a ballpark goal, A1C, of 7 to 8,

and these drugs bring that A1C down.

They bring down blood sugars.

And how they do that is they stimulate beta cells in the pancreas to produce and release insulin.

And with that mechanism of action, it's really, really important to understand from a physiological process what insulin does.

So insulin causes the sugar to come out of that bloodstream and therefore lowers blood sugar.

But in doing that through that process, whenever we either, whenever we either use insulin or utilize a drug that produces or stimulates the release of more insulin,

that's got the potential to drop down blood sugars too far.

Because again, we're doing things that are kind of beyond physiological processes and kind of read adapting that

situation. So whenever you have a drug that's going to stimulate the release of insulin or

kind of produce above and beyond insulin, there is always the potential for hypoglycemia.

So a lot of the other agents, so metformin, I've covered already on the podcast.

Obviously, I'm going to cover more coming up here, but a lot of the diabetes medications

don't necessarily have a high risk of hypoglycemia themselves,

but when you add them on to a sulfonyria and or insulin,

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