View source for Sulfonylurea toxicity

==Background==
*Sulfonylureas are a commonly prescribed oral diabetes medication, and include [[glyburide]], glimepiride, [[glipizide]] chlorpropamide, tolazamide
*Inhibit potassium efflux from pancreatic beta cells→ increased insulin release

==Clinical Features==
*[[Hypoglycemia]]
**Can occur at therapeutic doses in renally impaired patients
**Hypoglycemia often prolonged and severe
**Onset within 8 hours of ingestion
*'''Pediatrics''': one pill can kill!!

==Differential Diagnosis==
{{Hypoglycemia DDX}}

==Evaluation==
*[[Hypoglycemia]] + known or suspected ingestion
*BMP, creatinine, decrease in renal clearance may have led to toxicity
*Serial POC glucose measurements
*Routine ingestion labs if suspect intentional OD
**[[Acetaminophen]] and [[salicylate]] levels
**[[ECG]], look for QRS widening and QTc prolongation

==Management==
{{Sulfonylurea Toxicity}}

==Disposition==
*Admit
*Because of prolonged effect, not appropriate to discharge from ED even with normal glucose and patient tolerating PO, as hypoglycaemia may recur over 24h or more

==See Also==
*[[Hypoglycemia]]
*[[Diabetes medications]]

==External Links==

==References==
<references/>

[[Category:Toxicology]][[Category:Endocrinology]]