Anti Diabetes Research Paper

Faculty of pharmacy

Pharmacology and toxicology department

Clinical Pharmacology

PO512

Assignment

Drug interaction with Anti-diabetic drugs

Shimaa Kamal Ahmed 135763

Prof.Dr. Amany El-Brairy

Assistants

AL. Maha Shouman

AL. Heba Hossam

Introduction

Diabetes is a symptom of defective insulin action or secretion that can be diagnosed by a threshold of glycaemia (Karam, 1998). In addition Karam (1998) said that, diabetes patient will be suffered from a variety of signs and symptoms such as polyuria, polyphagia and polydipsia. Diabetes will cause many complications in cardiovascular system, kidney, eye, foot and nerves (Karam, 1998). Anti-diabetic drugs are classified into two categories:

1. Insulin injection

Karam (1998) showed that

Oral hypoglycemic drugs

Suitable for adults patients and can be classified into 4 main groups

According to Karam (1998), classification of oral anti-diabetic drugs

A. Alpha glucosidase inhibitors e.g. Miglitol

Mechanism of action In this class, there is an inhibition of alpha amylase that digests carbohydrate into di and monosaccharaides, so delays their absorption from the intestine, reduce the postprandial glycaemia and finally manage diabetes as well (White, 2003).

Uses

According to White (2003),

1. Prevents the possibilities of kidney damage and heart attacks

2. No lactose

Thiazides, corticosteroids, beta blockers, oral contraceptive, estrogen and calcium channel blocker: loss of glycemic control

2. Anticoagulant, salicylates, androgens, MAO.I., probencid and azole antifungal: hypoglycemia

3. Sulfonamide, NSAIDs and phenylbutazone: displace sulphonyurea from plasma protein

4. Allopurinol, probencid and salicylates: decrease urinary excretion

C. Biguanides e.g. metformin

Mechanism of action

Through decreasing glucose formation in the liver, developing insulin sensitivity, reducing glucose absorption in the intestine and decreasing glycogenlysis, anti-hyperglycemia will be produced (Sweet, et. al., 2008).

Uses

Used in combination with sulphonylurea to control hyperglycemia and reduce glucose concentration by 20% in fasting plasma level. It is also may be used to reduce blood pressure (Sweet, et. al., 2008).

Adverse effects GIT disturbance e.g. nausea, vomiting, diarrhea and anorexia and may cause increase in lactic acid levels (Sweet, et. al., 2008). Drug interaction

As Sweet et. al. (2008),

1. With cimetidine, procainamide and vancomycin: compete for elimination, so increase metformin concentration

2. With furosemide: increase metformin concentration and decrease furosemide half life

3. With vitamin B12 and folic acid: