Insulin and its preparations Sulfonyl ureas: Tolbutamide*, Chlorpropamide, Glipizide, Glimepiride, Glibenclamide. Biguanides: Metformin. Thiazolidinediones: Pioglitazone, Rosiglitazone. Meglitinides: Repaglinide, Nateglinide. Glucosidase inhibitors: Acrabose, Voglibose

1. Anti diabetic agents
SUBJECT:- MEDICINAL CHEMISTRY-II
B.PHARMACY
SEMSTER:- V SEM
PREPARED BY
Dr.D Mahendra,M.Pharm,PharmD-PB,(MBA)(Ph.D),.
Research Scholar at parul University
Asst Professor-Nova College of Pharmacy

8. CHEMISCAL CLASSIFICATION OF
ANTI DIABEBETIC AGENTS
Sulfonyl ureas: Tolbutamide*, Chlorpropamide,
Glipizide, Glimepiride, Glibenclamide.
Biguanides: Metformin.
Thiazolidinediones: Pioglitazone, Rosiglitazone.
Meglitinides: Repaglinide, Nateglinide.
Glucosidase inhibitors: Acrabose, Voglibose.

9. SULFONYL UREAS
Tolbutamide:-
The synthesis of tolbutamide involves addition reaction of
p-toluene sulfonamide and butyl isocyanate in the presence
of triethylamine and tetrahydrofuran.

10. SAR OF SULPHONYLUREAS
1.The benzene ring should contain a substitutent preferably in the para
position. The substituents, such as methyl, acetyl, amino, chloro, bromo,
trifluoro methyl, and dithiomethyl were found to enhance the
antihyperglycaemic activity.
2. When the para position of benzene is substituted with aryl
carboxamidoalkyl group (second-generation sulphonylureas, such as
glibenclamide) the activity was found to be enhanced further.

11. 3. The size of the group attached to the terminal nitrogen is
crucial for activity. The group should also impart
lipophilicity to the compound N-methyl and ethyl
substituents that show no activity, whereas N-propyl and
higher homologues were found to be active and the activity
is lost when the N-substituent contains 12 or more carbons.

12. CHLORPROPAMIDE-STRUCTURE & USES
Chlorpropamide is an oral anti-hyperglycemic agent used
for the treatment of non-insulin-dependent diabetes
mellitus (NIDDM). It belongs to the sulfonylurea class of
insulin secretagogues which act by stimulating β cells of
the pancreas to release insulin.

13. GLIPIZIDE -STRUCTURE & USES
Glipizide is used to treat high blood sugar levels caused by
a type of diabetes mellitus (sugar diabetes) called type 2
diabetes. In type 2 diabetes, your body does not work
properly to store excess sugar and the sugar remains in
your bloodstream

14. GLIMEPIRIDE -STRUCTURE & USES
Glimepiride is used to treat high blood sugar levels caused
by type 2 diabetes. It may be used alone, or in combination
with insulin or another oral medicine such as metformin. In
type 2 diabetes, insulin produced by the pancreas is not
able to get sugar into the cells of the body where it can
work properly.

15. GLIBENCLAMIDE -STRUCTURE & USES
Glibenclamide is used to lower the blood sugar level in
patients with type 2 diabetes mellitus that is not controlled
by diet and exercise alone. . It is used along with diet and
exercise to improve blood sugar control in adults with type
2 diabetes. Glibenclamide is an antidiabetic medication

16. BIGUANIDES
Metformin:-
M.O.A:- Its pharmacologic mechanisms of action are different from other
classes of oral antihyperglycemic agents. Metformin decreases hepatic
glucose production, decreases intestinal absorption of glucose, and
improves insulin sensitivity by increasing peripheral glucose uptake and
utilization.

17. USES OF METFORMIN

18. THIAZOLIDINEDIONES
M.O.A:- TZDs reduce insulin resistance in adipose tissue,
muscle and the liver. However, PPAR gamma is
predominantly expressed in adipose tissue. It is possible
that the effect of TZDs on insulin resistance in muscle and
liver is promoted via endocrine signalling from adipocytes.
Pioglitazone:-

19. PIOGLITAZONE USES
Pioglitazone is a diabetes drug (thiazolidinedione-type, also
called "glitazones") used along with a proper diet and
exercise program to control high blood sugar in patients
with type 2 diabetes.
It works by helping to restore your body's proper response
to insulin, thereby lowering your blood sugar.Controlling
high blood sugar helps prevent kidney damage, blindness,
nerve problems, loss of limbs, and sexual function
problems. Proper control of diabetes may also lessen your
risk of a heart attack or stroke.

20. ROSIGLITAZONE-STRUCTURE & USES
Rosiglitazone is used to treat a type of diabetes mellitus
called type 2 diabetes.
It may be used alone or with other medicines such as
Metformin or sulfonylurea agents.
Rosiglitazone is used together with a proper diet and
exercise to help control blood sugar levels.

21. Meglitinides
Mechanism of action:- Meglitinides (glinides) are based
on the sulfonylurea moiety of glibenclamide (called
meglitinide). They bind to the SUR1 receptor on the β-cell,
although with lower affinity than sulfonylureas, and
stimulate insulin release in the same way.
USES:- Repaglinide is used together with diet and exercise to treat
high blood sugar (glucose) levels in patients with type 2 diabetes.
Repaglinide works by causing your pancreas to release more
insulin into the blood stream. This medicine does not help
patients who have insulin-dependent or type 1 diabetes.

22. Nateglinide
Nateglinide is used together with diet and exercise to
control blood sugar levels in patients with type 2 diabetes.
It works by causing your pancreas to release more insulin
into the blood stream. This medicine does not help patients
who have insulin-dependent or type 1 diabetes.

23. Glucosidase inhibitors
Mechanism of ActionAlpha-glucosidase inhibitors inhibit
the absorption of carbohydrates from the small intestine.
They competitively inhibit enzymes that convert complex
non-absorbable carbohydrates into simple absorbable
carbohydrates. These enzymes include glucoamylase,
sucrase, maltase, and isomaltase.

24. Acarbose is used to treat type 2 diabetes. Normally, your
pancreas releases insulin into the blood stream after you
eat. Insulin is used by all the cells in your body to help turn
the food you eat into energy. This is done by using glucose
(sugar) in the blood as quick energy.
Voglibose:- Voglibose is an alpha-glucosidase inhibitor
that is used to treat diabetes mellitus by lowering post-
prandial blood glucose levels. It helps to delay the
absorption of sugar in the body and thereby it reduces the
macrovascular complication risks.