Glimepiride is an example of a ______.

Appeared in: DSSSB 6 September 2024

Explanation

Glimepiride is classified as a second-generation sulfonylurea, an oral medication used to manage type 2 diabetes mellitus.
Its primary mechanism of action is to stimulate the beta cells in the pancreas to secrete more insulin.
This is achieved by binding to sulfonylurea receptors on the beta-cell surface, which leads to the closure of ATP-sensitive potassium channels, causing cell depolarization and subsequent insulin release.

Option B: This class of drugs, with Metformin as the primary example, works mainly by decreasing glucose production in the liver (gluconeogenesis) and improving insulin sensitivity in peripheral tissues. It does not primarily stimulate insulin secretion.
Option C: Although they also stimulate insulin release, meglitinides (e.g., Repaglinide) have a different chemical structure, a faster onset, and a shorter duration of action compared to sulfonylureas. They are taken just before meals to control postprandial glucose spikes.
Option D: Also known as thiazolidinediones (TZDs), this class (e.g., Pioglitazone) works by increasing the sensitivity of muscle, fat, and liver cells to insulin. They are insulin sensitizers, not insulin secretagogues.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of oral antidiabetic drugs as background academic context rather than a clinical decision trigger.
Understanding drug classifications is crucial for nurses to anticipate potential side effects, provide accurate patient education, and recognize contraindications. The primary risk with sulfonylureas is hypoglycemia.
Nurses must educate patients on the signs and symptoms of hypoglycemia (e.g., sweating, tremors, confusion) and how to manage it with fast-acting carbohydrates.
What if? If a patient has a known sulfa allergy, sulfonylureas like Glimepiride would be contraindicated. The nurse should anticipate the prescriber choosing a drug from a different class, such as Metformin (a biguanide) or Sitagliptin (a DPP-4 inhibitor).

How to Approach the Question

First, identify the drug name in the question stem: 'Glimepiride'.
This is a factual recall question that requires knowledge of pharmacology.
Access your memory or knowledge base regarding the classification of common oral antidiabetic medications.
Recall that drugs with the '-ide' suffix (Glimepiride, Glipizide, Glyburide) are typically sulfonylureas.
Compare this classification with the given options to find the correct match.
Mentally confirm the mechanisms of the other drug classes (distractors) to ensure they are incorrect and strengthen your choice.

Concept Tested & Keywords

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E6 Pharmacology Nurses Shanbhag 3e p. 274-276

E6 Pharmacology Katzung 16e p. 1197-1199

Practise the full DSSSB 6 September 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.