Gliquidone
An oral hypoglycemic agent used in the management of type 2 diabetes mellitus
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Gliquidone is an oral hypoglycemic agent belonging to the class of sulfonylureas. It is primarily used in the management of type 2 diabetes mellitus. Gliquidone works by stimulating the release of insulin from the beta cells of the pancreas.
Pharmacology
Gliquidone is a second-generation sulfonylurea. It binds to the sulfonylurea receptor on the beta cells, leading to the closure of ATP-sensitive potassium channels. This action results in the depolarization of the cell membrane and the opening of voltage-gated calcium channels, which increases intracellular calcium concentration and stimulates insulin secretion.
Clinical use
Gliquidone is indicated for the treatment of type 2 diabetes mellitus in patients who cannot achieve adequate glycemic control with diet and exercise alone. It is particularly useful in patients with renal impairment as it is primarily metabolized by the liver and excreted in the bile.
Side effects
Common side effects of gliquidone include hypoglycemia, weight gain, and gastrointestinal disturbances such as nausea and diarrhea. Rarely, it may cause allergic reactions or hematological disorders.
Contraindications
Gliquidone is contraindicated in patients with type 1 diabetes mellitus, diabetic ketoacidosis, and those with known hypersensitivity to sulfonylureas. Caution is advised in patients with hepatic impairment.
Mechanism of action
Gliquidone acts by binding to the sulfonylurea receptor on the pancreatic beta cells. This binding inhibits the efflux of potassium ions, leading to cell depolarization. The subsequent influx of calcium ions triggers the exocytosis of insulin-containing granules, thereby increasing insulin secretion.
Metabolism and excretion
Gliquidone is extensively metabolized in the liver to inactive metabolites. It is excreted primarily in the bile, making it suitable for use in patients with renal impairment. The drug has a relatively short half-life, which reduces the risk of prolonged hypoglycemia.
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