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Glipizide
💊 Glipizide is a short-acting sulphonylurea used in the management of Type 2 Diabetes Mellitus (T2DM). ⚠️ It can cause hypoglycaemia (especially if meals are missed), but the risk is lower than with long-acting agents like glibenclamide. 👉 Always check the BNF for the latest details.
⚙️ Mode of Action
- Stimulates pancreatic β-cell receptors → insulin release 🍬.
- Suppresses hepatic gluconeogenesis 🛑, reducing glucose output from the liver.
- Overall: lowers blood glucose by ↑ insulin and ↓ hepatic glucose production.
📌 Indications
- Type 2 Diabetes Mellitus (T2DM) – when lifestyle ± metformin are inadequate.
💊 Dose
- 2.5–5 mg with food (usual max: 20 mg/day).
- Take with meals to reduce risk of hypos.
🔗 Interactions
- ⬆️ Risk of hypoglycaemia with:
- Chloramphenicol
- Sulphonamides, Co-trimoxazole
- Warfarin
- Fibrates
- Alcohol 🍷 can potentiate hypo risk.
⚠️ Cautions
- 💡 Use with caution in elderly or those with renal/hepatic impairment → ↑ hypo risk.
- Obesity: metformin usually preferred first-line.
- Acute illness/surgery: consider switching to VRIII (Variable Rate IV Insulin Infusion).
⛔ Contraindications
- Type 1 Diabetes Mellitus.
- Diabetic ketoacidosis.
- See BNF for full list.
💥 Side Effects
- 🍬 Hypoglycaemia (classic exam pearl).
- ⚖️ Weight gain.
- 😣 GI upset (nausea, diarrhoea).
- 🌸 Rash or hypersensitivity reactions.
- 🩸 Rare: blood dyscrasias (agranulocytosis, haemolytic anaemia).
- Hepatic toxicity (rare but important).
🧠 Clinical Pearls
- Safer than glibenclamide in the elderly due to its shorter duration of action.
- Still carries hypo risk – always counsel on "hypo rules" (carry glucose, don’t skip meals, recognise warning signs).
- Useful when patients cannot tolerate metformin or need additional control before insulin is started.
📚 References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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