Glibenclamide overdose
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Hypoglycaemia: 4 case reports Four patients* developed severe hypoglycaemia after ingesting overdoses of glibenclamide [glyburide]. A 2-year-old boy presented after accidentally ingesting ten 5mg glibenclamide tablets. He was drowsy, with a blood glucose level of 2.2 mmol/L [time to reaction onset not stated]. Dextrose was administered, but he remained irritable and hypoglycaemic. Two additional glucose boluses were required, followed by octreotide. Two hours after octreotide administration, his blood glucose had normalised. He remained stable thereafter, with no further signs of hypoglycaemia. Two teenagers, aged 15 and 14 years [sexes not stated] ingested glibenclamide as part of a suicide attempt [dosages not stated], and subsequently presented with symptoms of sulfonylurea intoxication, including severe hypoglycaemia [times to reactions onset not stated]. Glucose was administered, but rebound hypoglycaemia developed, requiring further glucose administration [patient outcomes not stated]. An 18 month-old boy was found with glibenclamide pills in his mouth [dosage not stated], and quickly became thirsty and irritable. He subsequently experienced a seizure, and emergency services were called; his blood glucose level was 1.3 mmol/L [time to reaction onset not stated]. Dextrose was administered, but he had an additional seizure. At hospital, he received further treatment with dextrose, as well as octreotide. His blood glucose level normalised and, 48 hours later, he was discharged without further complications. * the authors described another six cases of suspected sulfonylurea ingestion, but no hypoglycaemia or other clinical manifestations of intoxication developed in these patients. Glatstein M, et al. Sulfonylurea intoxication at a tertiary care paediatric hospital. Canadian Journal of Clinical Pharmacology 17: e51-e56, No. 1, 2010 803015293 Canada
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Reactions 22 May 2010 No. 1302
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