SULPHONYL UREA
Acetohexamide,Glibornide,Glipizide,Tolbutamide,Chlorpropamide,Glibenclamide (Glyburide),Gliclazide,Glimepiride,Gliquidone,Tolazamide
Clinical effects
Hypoglycaemia
Aspiration pneumonia or pulmonary oedema is sometimes seen particularly after seizures or prolonged hypoglycaemia.
Hypokalaemia, and other electrolyte imbalance, often occurs during prolonged treatment with glucose.
Investigations
Blood glucose (Normal range of FBS, 4.2-6.4 mmol/L (75-115 mg/dL) Renal function
The ECG should be monitored if significant hypokalaemia occurs.
Treatment
Supportive IV Glucose
GI Decontamination (Oral activated charcoal)
Antidotes
- Octreotide, a somatostatin analogue, 1-1.5mg/kg IV or SC, suppresses insulin release
- Diazoxide, a bolus of 300mg slow IV and infusion of 50-100mg/Hourly IV, has a similar
effect on insulin release to octreotide. - Glucagon – Not routinely given