Endocrinology Book

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Sulfonylurea Overdose

Aka: Sulfonylurea Overdose, Sulfonylurea Toxicity
  1. Signs and Symptoms
    1. Coma
    2. Decreased Appetite
    3. Dizziness
    4. Hypoglycemia
    5. Lethargy
    6. Seizures
    7. Weakness
  2. Management: Adults
    1. Dextrose bolus followed by continuous infusion (dose based on degree of Hypoglycemia)
    2. Octreotide (Sandostatin) 50-100 mcg/dose SQ twice to three times daily
    3. Glucagon 1 mg per dose and may repeat every 20 minutes
      1. Only transient elevation in Glucose to temporize until definitive other management
  3. Management: Children
    1. Dextrose bolus followed by continuous infusion
      1. Age 1 to 24 months: Dextrose 25% IV 2-4 ml/kg
      2. Age >24 months: Dextrose 50% IV 1-2 ml/kg
    2. Octreotide (Sandostatin) 4-5 mcg/kg/day SQ divided every 6 hours to maximum of 50 mcg/dose
    3. Glucagon
      1. Infants: 0.025 mg/kg/dose every 20 minutes
      2. Children: 0.5 mg/dose every 20 minutes
      3. Only transient elevation in Glucose to temporize until definitive other management
  4. References
    1. Harrigan (2001) Ann Emerg Med 38(1): 68-78 [PubMed]
    2. Rath (2008) J Paeditr Child Health 44(6): 383-4 [PubMed]

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