The mechanism of action for sulfonylureas is they stimulate insulin release from the pancreas.
Sulfonyureas are indicated for T2DM. The mechanism of action for sulfonylureas is they stimulate insulin release from the pancreas. Hypoglycemia is common with these medications, but toxicities can lead to refractory cases. The class includes glipizide, glyburide, and glimeperide. They can be dangerous because increase additive hypoglycemic risks, and are dependent on taking it before having meals.
In the setting of toxicity, you are extra sensitive to dextrose. Patients will have their glucose replaced with boluses of D50W, and sulfonyureas will have a sensitive response causing an abrupt dip in your serum glucose. This response to dextrose should make you suspicious for a sulfonyurea toxicity.
Octreotide, a somatostatin analogue, inhibits insulin release from the pancreas, essentially counteracting the effects of lingering sulfonyureas. Be careful with inducing hypertension and bradycardia with ocreotide, your risk is lower with SUBQ vs IV administration. Severe cases will likely require concentrated dextrose and glucocorticoids, we’ll cover this when we talk insulin overdoses. For more PHARMFAX in the drug bank, let me know what you want to learn, link in the bio.
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