Pharmacology for Dentistry

Antidiabetic Agents 277

lipodystrophy (atrophy at the site of injection),

insulin neuropathy and weight gain (obesity).

Therapeutic Uses

Insulin is used in:

• Insulin dependent diabetes mellitus
  (IDDM).


• Diabetic ketoacidosis or diabetic coma.
  HUMINSULIN
  Huminsulin 30/70 [biphasic isophane
  insulin injection (30% soluble insulin and 70%
  isophane insulin)] is a mixture of soluble
  human insulin injection, a short acting blood
  glucose lowering agent and isophane insulin
  human suspension, an intermediate acting
  blood glucose lowering agent.

Adverse Effects

Local allergy: Patients occasionally

experience redness, swelling, and itching at

the site of injection of insulin.

Systemic allergy: Less common, but

potentially more serious, is generalized

allergy to insulin, which may cause rash

over the whole body, shortness of breath,

wheezing, reduction in blood pressure, fast

pulse, or sweating. Severe cases may be life

threatening.

ORAL ANTIDIABETIC AGENTS

These are the agents which are effective

orally and lower the elevated blood glucose

levels. They are classified as in table 8.2.2.

SULFONYLUREAS

These drugs stimulate insulin secretion

from pancreatic βββββ-cells (so called

‘sulfonylurea receptors’) which cause

depolarisation by reducing conductance of

Table 8.2.2: Classification of oral antidiabetic agents.

I. Sulfonylureas

i. First generation

Tolbutamide (RASTINON) 0.5-2 g/day

Chlorpropamide (COPAMIDE) 100-500 mg/day

Tolazamide 0.125-1.0 g/day

ii. Second generation

Glibenclamide (BETANASE) 5-20 mg/day

Glipizide (DIBIZIDE) 5-20 mg/day

Gliclazide (GLIZID) 160-320 mg BD

Glimepiride (GLIMER) 1-6 mg OD

II. Biguanides

Metformin (GLYCOMET) 250 mg to 3.0 g/day

III.Meglitinides

Repaglinide (RAPILIN) 0.25-4 mg/day

Nateglinide (GLINATE) 60 mg/day

IV.Thiazolidinediones

Rosiglitazone (ENSELIN) 4-8 mg OD-BD

Pioglitazone (GLIZONE) 15-45 mg OD

V. ααααα-Glucosidase inhibitors

Acarbose (GLUBOSE) 50-200 mg TDS