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Wes Palatnick, MD, FRCPC; Robert C. Meatherall, PhD, DABFT; Milton Tenenbein, MD, FRCPC

Arch Intern Med. 1991;151(9):1859-1862.

Abstract
We retrospectively reviewed our 10-year experience with the management of sulfonylurea overdose. There were 40 overdoses in 37 patients aged 1 to 78 years, with two deaths and one patient being left in a chronic vegetative state. Blood sugar levels ranged from normal to severe recalcitrant hypoglycemia. Maximal duration of recurrent hypoglycemia was 82 hours. In 21 of 31 patients with hypoglycemia, response to hypertonic glucose therapy was poor, resulting in recurrent hypoglycemia. Six of these patients were treated with intravenous diazoxide and had prompt correction. Overdose of sulfonylurea drugs may produce severe, protracted hypoglycemia poorly responsive to hypertonic glucose therapy. Treatment with diazoxide is rational and effective and may be lifesaving.

(Arch Intern Med.1991;151:1859-1862)

Author Affiliations
From the Departments of Family Medicine (Dr Palatnick), Pediatrics (Dr Tenenbein), and Pharmacology (Drs Meatherall and Tenenbein), The University of Manitoba; Department of Clinical Chemistry, St Boniface General Hospital, Winnipeg (Dr Meatherall); and the Manitoba Poison Control Centre (Dr Tenenbein), Winnipeg, Manitoba.

Footnotes
Accepted for publication March 21, 1991.

Presented at the annual meeting of the American Academy of Clinical Toxicology, Atlanta, Ga, October 14, 1989.

Reprint requests to Children's Hospital, 840 Sherbrook St, Winnipeg, Manitoba, Canada R3A 1S1 (Dr Tenenbein).

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