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Sulfonylurea Overdose

Aka: Sulfonylurea Overdose, Sulfonylurea Toxicity

Signs and Symptoms
1. Coma
2. Decreased Appetite
3. Dizziness
4. Hypoglycemia
5. Lethargy
6. Seizures
7. Weakness
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
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
References
1. Harrigan (2001) Ann Emerg Med 38(1): 68-78
2. Rath (2008) J Paeditr Child Health 44(6): 383-4

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 12/21/2011 and last published on 6/18/2013.

This is one of 5909 pages in the Family Practice Notebook