Honor society of nursing stti many people who experience hypoglycemia frequently and are at risk of severe hypoglycemia, such as people with diabetes, carry glucose tablets or a glucagon kit to use in case their blood sugar begins to drop. However, not all drugs affect patients the same way. Many people think of hypoglycemia as something that only occurs in people with diabetes. Listed below are some drugs that may cause constipation. Hypoglycemia is a common problem with an increasing incidence in critically ill or extremely low birthweight infants. Hypoglycemia also triggers the release of body hormones, such as epinephrine and norepinephrine. Doseresponse of methadoneinduced hypoglycemia male cd1 mice n. Beyond insulin dosing errors, common preventable sources of iatrogenic hypoglycemia are improper prescribing of other glucoselowering medications, inappropriate.
Reactive hypoglycemia is symptoms of low blood sugar. Beta blockers can mask signs and symptoms of hypoglycemia except sweating. This medicine is used as an emergency treatment for severe low blood sugar in diabetic patients, especially if they are not able to take sugar by mouth. Drug induced hypoglycemia is more common in older patients with underlying comorbidities and in those taking glucose lowering medications, especially insulin and the sulfonylurea drugs glyburide, glipizide, and glimepiride 15. Nutrition management of low blood sugar without diabetes. Mollenkopf, pharmd, mba, bcps krysia hudson, dnp, rn, bc assistant professor johns hopkins. Drug induced hypoglycaemia is usually mild but may be severe. Nondiabetic hypoglycemia, a rare condition, is low blood glucose in people who do not have diabetes. The direct cause of drug induced hypoglycemia is the unregulated use of one of several types of medications that cause blood sugar levels to drop. Both recognition and prevention of druginduced hypo glycemia require awareness of the clinical conditions favor ing its occurrence and the drugs and drug.
Biguanides introduction the biguanide metformin is the drug of choice as initial therapy for a newly diagnosed patient with type 2 diabetes as an adjunct to diet and exercise. Druginduced low blood sugar is low blood glucose that results from taking medicine. Even when diabetes is managed very carefully, the medicines used to treat diabetes can result in druginduced low blood sugar. Check fingerstick bg if patient experiences any symptoms of hypoglycemia including pallor, clammy skin, hunger, restless sleep, fatigue. Drugs that can affect blood glucose levels diabetes in control. This article discusses in detail the various oral hypoglycemic drugs. Metformin, sulfonylureas, or other antidiabetes drugs and. What drugs should not be used in combination with oral hypoglycemics. The purpose of todays activity is for students to begin to understand how different drugs can affect the body. Eating guidelines for reactive hypoglycemia reactive hypoglycemia is low blood glucose sugar that occurs within four hours after eating.
Naranjo scale score of 7 indicated that the likelihood of tigecycline causing severe hypoglycemia was probable. Complex i is especially susceptible to no damage, and animals administered natural and synthetic complex i antagonists have undergone death of neurons 4951. Druginduced hypoglycemia drug induced hypoglycemia. Figure 3 linagliptin mechanism of action source summary of clinical pharmacology studies, figure 3. Check the full list of possible causes and conditions now.
Fourteen of our patients used drugs that were implicated as potentiating drugs for hypoglycemia by interacting with insulin or oral hypoglycemic agents, by competingforproteinbinding,orbyinterferingwithrenal excretion. Fasting hypoglycemia, which may be related to a disease. A low plasma glucose value is a necessary, but not sufficient, finding for the diagnosis of hypoglycemia. American academy of emergency medicine resident and. Complex i dysfunction has been associated with leber hereditary optic neuropathy, parkinsons disease, and other.
Symptoms of reactive hypoglycemia may include anxiety, fast heartbeat, irritability feeling very stressed or nervous, shaking, sweating, hunger, dizziness, blurred vision, difficulty thinking and. Hypoglycemia treatment treatment for low blood glucose. Drug induced hepatotoxicity and nephrotoxicity may lead in certain circumstances to hypoglycaemia. More frequent blood glucose monitoring and dose adjustments may be required. Hypoglycemia harrisons principles of internal medicine. Pdf druginduced hypoglycemia is a significant adverse effect that may cause important morbidity. In postprandial syndrome or reactive hypoglycemia, symptoms may occur within 2 to 4 hours after a meal. Hypoglycaemia may occur in any severely ill fasting patient given parenteral quinidine.
We searched electronic databases medline, embase, web of. This too most often occurs about 4 hours after a meal and symptoms improve right away with intake of carbs. Patient care management diabetes drugs 1 sulfonylureas. The connection between depression, addiction and hypoglycemia. The term hypoglycemia does not show up in any search of medline, except when mentioned in connection with diabetes. Hypoglycemia in metformin monotherapy is generally a consequence of a combination with poor food intake, strenuous exercise, coingestion of other anithyperglycemic drugs or comorbidity 5 9. Hypoglycemia is most common in people with diabetes. Hypoglycemia insulin reaction 2 moderate symptoms o confusion o headache o poor coordination severe symptoms o unconsciousness o seizures o coma never drive when your blood sugar is low.
E09 secondary diabetes due to drugs or chemicals code also with t36t65 codes e10 type 1 diabetes due to autoimmune process in child or young adult e11 type 2 diabetes due to shortage of insulin or poor insulin transport e other specified dm due to genetic. Hypoglycemia, also known as low blood sugar, is a fall in blood sugar to levels below normal. Pdf on oct 10, 2011, marek pytliak and others published drugs and. Metformin is contraindicated in certain patients to prevent lactic acidosis, a rare. Glucose is the main source of energy for your body and brain. The most common cause is medications taken by people with diabetes. Weakness or fatigue headache irritable what can you treat by eating 3 to 4 glucose tablets or 3 to 5 hard candies you can chew quickly such as peppermints, or by drinking. It is also used during diagnostic endoscopy or radiology examinations of the stomach and other digestive organs. Other than certain medicines, the following can also cause blood sugar glucose level to drop. Hypoglycemia clinical pharmacy and pharmacology jama. Each group received saline, racemic dlmethadone 5, 10. Winner of the standing ovation award for best powerpoint templates from presentations magazine. Drugs are the most common cause of hypoglycemia table 3 1.
Pharmacologic glycemic management of type 2 diabetes in adults. Effective clinical management can be handled through awareness of this drug induced adverse effect on blood glucose levels. American academy of emergency medicine resident and student association 50 drugs eve emee piia od ow card 2 of 50 moa. Yes, some type 2 diabetics control their condition with diet and exercise alone, without drugs. In patients with prolonged recurrent hyperinsulinemic hypoglycemia or unknown cause of ias, immunosuppressive therapy may help to shorten the duration of the disease. Although most cases of druginduced hypoglycemia were described in patients with diabetes taking glucoselowering. Its potential association with brain damage and neurodevelopment delay make it an important topic. Recurrent hyperinsulinemic hypoglycemia would disappear after discontinuing drugs causing ias.
Dose adjustments andor additional agents should be instituted to achieve target a1c within 3 to 6 months. Insulin is one of the most common drugs causing adverse events in hospitalized patients, and errors in insulin dosing andor administration occur relatively frequently 66,67. Drug induced hypoglycemia is a significant adverse effect that may cause important morbidity. Medications used in the treatment of hypoglycemia include the following. But other drugs and a variety of conditions many rare can cause low blood sugar in people who dont have diabetes hypoglycemia needs immediate treatment when blood sugar levels are low. Druginduced hypoglycemia diabetes spectrum american. Hypoglycemia can also be caused by certain other medications and by heavy alcohol drinking. Hypoglycemia is most commonly caused by drugs used to treat diabetes mellitus or by exposure to other drugs, including alcohol.
If not due to maternal hyperglycemia, in most cases it is multifactorial, transient and easily supported. Your brain relies on these hormones to raise blood sugar levels. Another reason is that the term hypoglycemia is a misnomer and is bound to confuse many medical practitioners who understand the. Some drugs may also induce hypoglycaemia by causing pancreatitis. Diabetics not being treated with pills or insulin rarely need to worry about hypoglycemia. Low blood sugar hypoglycemia is common in people with diabetes who are taking insulin or other medicines to control their diabetes. Most cases are observed, when an individual who does not have diabetes takes medications, which are used to treat diabetes. Hyperinsulinemic hypoglycemia associated with insulin. In a minority of cases, hypoglycemia turns out to be due to. This may result in a variety of symptoms including clumsiness, trouble talking, confusion, loss of consciousness, seizures or death. As you can learn in the causes article, hypoglycemia causes fall into two categories. The release of these hormones causes additional symptoms of tremor, sweating, rapid heartbeat, anxiety and hunger. Furthermore, some drugs have been associated to interact with metformin, causing hypoglycemia e.
You need to drink or eat some form of sugar as soon as you have any symptoms of. Chapter antidiabetic agents 2 charles ruchalski, pharmd, bcps drug class. Glucose supplements eg, dextrose glucoseelevating agents eg, glucagon, glucagon intranasal inhibitors of. Beta blockers mask signs and symptoms of hypoglycemia e. However, a number of other disorders, including critical organ failure, sepsis and inanition, hormone deficiencies, non. They include kidney, liver, or heart failure, infection, low levels of certain hormones such as cortisol or growth hormone, certain tumors, some types of. Ppt antiepileptic drugs powerpoint presentation free. The odds ratio of developing hypoglycemia in association with current metformin use was 1. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. A feeling of hunger, sweating, shakiness and weakness may also be present. Oversecretion of insulin appears to have been the cause of the hypoglycemia in our patient. Hypoglycaemia is feared by many patients not only because of the associated physical discomfort. Documentation of hypoglycemia treatment protocol file this form within the progress note section of the chart 158801u imprint patient identification here general information.
The common causes of acute hypoglycemia are related to therapy for diabetes mellitus insulin and its analogues or oral antidiabetic drugs. Your treatment plan for hypoglycemia low blood sugar depends on what is causing your blood sugar level to drop too low. Reactive hypoglycemia, which happens within a few hours of eating a meal. Choice of secondline antihyperglycemic agents should be made based on individual patient characteristics, patient preferences, any contraindications to the drug, glucoselowering efficacy, risk of hypoglycemia, affordabilityaccess. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect.