Home Drug Guide Glyburide

Drug Guide

Generic Name

Glyburide

Brand Names Micronase, Diabeta, Glynase, Glyburide (micronized)

Classification

Therapeutic: Antidiabetic agent

Pharmacological: Sulfonylurea

FDA Approved Indications

  • Management of type 2 diabetes mellitus as an adjunct to diet and exercise

Mechanism of Action

Glyburide stimulates insulin release from pancreatic beta cells by binding to sulfonylurea receptors, thereby increasing insulin secretion and decreasing blood glucose levels.

Dosage and Administration

Adult: Typically, 2.5 to 5 mg once daily before breakfast. Dose may be adjusted based on glycemic response, up to a maximum of 20 mg/day.

Pediatric: Not recommended for use in children.

Geriatric: Initial dose should be low, with careful monitoring due to increased risk of hypoglycemia.

Renal Impairment: Use with caution; may require dose adjustment or discontinuation due to accumulation.

Hepatic Impairment: Use with caution; careful monitoring recommended.

Pharmacokinetics

Absorption: Well absorbed from the gastrointestinal tract.

Distribution: Widely distributed; crosses the placenta.

Metabolism: Metabolized in the liver via oxidation and conjugation.

Excretion: Excreted primarily in feces and urine.

Half Life: 10 hours approximately.

Contraindications

  • Known hypersensitivity to glyburide or sulfonylureas.
  • Diabetic ketoacidosis.

Precautions

  • Use with caution in patients with hepatic or renal impairment, in the elderly, and during pregnancy and lactation. Increased risk of hypoglycemia in these populations.

Adverse Reactions - Common

  • Hypoglycemia (Common)
  • Gastrointestinal disturbances (nausea, abdominal pain) (Less common)

Adverse Reactions - Serious

  • Severe hypoglycemia (Serious)
  • Jaundice, hepatotoxicity (Rare)
  • Allergic skin reactions (Rare)

Drug-Drug Interactions

  • Other antidiabetic agents, especially insulin and meglitinides, increase hypoglycemia risk.
  • Macrolide antibiotics (e.g., erythromycin) may enhance hypoglycemic effect.

Drug-Food Interactions

  • Alcohol may potentiate hypoglycemia.

Drug-Herb Interactions

  • St. John’s Wort may decrease glyburide effectiveness.

Nursing Implications

Assessment: Monitor blood glucose levels regularly. Assess for signs of hypoglycemia.

Diagnoses:

  • Risk for unstable blood glucose levels
  • Risk for hypoglycemia

Implementation: Administer with breakfast or the first main meal of the day. Educate patient on recognizing and managing hypoglycemia.

Evaluation: Evaluate blood glucose control regularly; adjust dose as needed.

Patient/Family Teaching

  • Take medication as prescribed, with meals.
  • Recognize signs of hypoglycemia and how to treat it.
  • Maintain dietary and activity recommendations.
  • Avoid alcohol and excess activity that could cause hypoglycemia.

Special Considerations

Black Box Warnings:

  • Risk of severe hypoglycemia, which can be life-threatening.

Genetic Factors: Genetic polymorphisms may affect drug metabolism and response.

Lab Test Interference: May interfere with certain laboratory tests, including blood glucose measurements.

Overdose Management

Signs/Symptoms: Severe hypoglycemia—confusion, seizure, coma.

Treatment: Administer oral glucose if conscious; intramuscular or intravenous glucose for unconscious patients. Seek immediate medical care.

Storage and Handling

Storage: Store at room temperature away from moisture and heat.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.