Sulfonylureas include:
(1) tolbutamide (Orinase)
(2) chlorpropamide (Diabinese)
(3) glyburide (Micronase, DiaBeta, Glynase)
(4) glipizide (Glucotrol)
Mechanism of action: increased secretion of insulin by the pancreatic islet cells
Absolute contraindications:
(1) hypersensitivity to sulfa drugs or other sulfonylureas
(2) history of adverse hematologic response to the sulfonylurea (cytopenia, aplastic anemia)
Relative contraindications:
(1) insufficient pancreatic tissue (lack of insulin secretory capacity)
(2) glyburide if history of glyburide-induced hepatitis
(3) chlorpropamide if history of chlorpropamide-induced cholestatic jaundice
(4) history of sulfonylurea-induced porphyria
(5) history of photoxicity associated with sulfonylurea therapy
(6) history of SIADH while taking chlorpropamide or tolbutamide.
Precautions:
(1) Avoid alcohol if a disulfiram-like reactions occurs.
