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Sulfonylureas
- Sulfonylureas cause insuline release via cAMP/protein kinase C
- All sulfonylurea overdoses should be admitted for 24 hrs regardless of symptoms
- Antidote for recurrent hypoglycemia due to sulfonylureas (overdose or therapeutic misadventure) is octreotide, after your glucose
- Octreotide, a somatostatin analogue, turns of insulin secretion completely
- Octreotide 50 mcg SQ q 6 hrs for 24 hrs then observe for hypoglycemia 12-24 hrs
Fasono et al. Comparison of Octreotide and Standard Therapy Versus Standard Therapy Alone for the Treatment of Sulfonylurea-Induced Hypoglycemia. Ann Emerg Med 2007 Aug 29.