Drugs online research references
Am J Hypertens. 1989 May;2(5 Pt 1):382-6.
Prorenin and vascular complications of diabetes.
Luetscher JA, Kraemer FB, Wilson DM.
Department of Medicine, Stanford University School of Medicine, California.
A high plasma prorenin is a marker of microvascular complications of diabetes. We have followed 56 adults and 120 children with uncomplicated insulin-dependent (type 1) diabetes. When plasma prorenin rises above the normal range in an adolescent or adult with type 1 diabetes, signs of nephropathy, retinopathy, or neuropathy follow within one to two years. The earliest sign may be intermittent microalbuminuria, which can often be abolished by improved control of hyperglycemia. The association between increased plasma prorenin and complications of noninsulin-dependent (type 2) diabetes is less reliable in patients with hypertension and in those receiving medication that affects plasma prorenin. The oral hypoglycemic agent, glipizide, lowers plasma prorenin, but its effect on prognosis is unknown. Plasma prorenin and renin decline as blood pressure rises, whereas the prevalence of micro- and macroalbuminuria increases. Many drugs used to control hypertension affect the level of prorenin. In the majority of our patients with type 2 diabetes who are hypertensive or are taking a medication that affects plasma prorenin, microalbuminuria may prove to be a more reliable warning of vascular complications.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2655663&dopt=Abstract
Horm Metab Res. 1989 Mar;21(3):132-6.
The combined use of insulin and sulfonylurea therapy in patients with non-insulin dependent diabetes mellitus.
Reaven GM, Fraze E, Chen NY, Hollenbeck C, Chen YD.
Department of Medicine, Stanford University School of Medicine, California.
This study was initiated in order to evaluate the clinical efficacy of glipizide treatment in 18 patients with non-insulin dependent diabetes mellitus in poor glycemic control with insulin. Insulin dose was kept constant, and various facets of carbohydrate and lipid metabolism were evaluated before and from 4-6 months after the addition of glipizide. The results indicated that fasting and post-prandial glucose concentration were significantly (P less than 0.001) reduced following glipizide treatment, associated with a commensurate fall in glycosylated hemoglobin concentration. The average fall in fasting plasma glucose concentration in the total patient group approximated 60 mg/dl, and the mean decrement in 8 of the 18 patients who had a fall of more than 70 mg/dl in fasting glucose was 93 mg/dl. These results demonstrate that the addition of glipizide to the treatment program of patients with non-insulin dependent diabetes mellitus poorly controlled on insulin can lead to substantial clinical benefit.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2663691&dopt=Abstract
Naunyn Schmiedebergs Arch Pharmacol. 1989 Sep;340(3):328-32.
How do sulfonylureas approach their receptor in the B-cell plasma membrane?
Zunkler BJ, Trube G, Panten U.
Institut fur Pharmakologie und Toxikologie, Universitat Gottingen, Federal Republic of Germany.
Since it was unknown whether the uncharged or the anionic form of hypoglycemic sulfonylureas and meglitinide is the effective modulator of ATP-dependent K+ channels and insulin secretion, we studied the inhibitory effects of tolbutamide and meglitinide on the ATP-dependent K+ current at different external pH. The whole-cell configuration of the patch-clamp technique was used in mouse pancreatic B-cells. When the concentrations of the undissociated forms of these drugs were kept constant at increasing pH of the bath solution (6.4 to 8.4), the rate of development and the degree of K+ channel block varied only slightly. Raising the pH-value in the bath solution at constant total concentration of tolbutamide diminished both the rate of development and the degree of K+ channel block. It is concluded that the undissociated forms of tolbutamide and related compounds are the effective forms. Examination of the K+ current records during the application and removal of different concentrations of tolbutamide, meglitinide, glipizide and glibenclamide at pH 7.4 indicated that the kinetics of the current records reflected not only association and dissociation of the drug-receptor complex but perhaps also the kinetic of drug distribution between bath and the lipid phase of the plasma membrane. As there is evidence against an interaction between sulfonylureas and their receptor via a binding site freely accessible from the cytoplasm, the drugs probably get access to their binding site on the receptor from the lipid phase of the B-cell plasma membrane.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2682269&dopt=Abstract
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