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Oral hypoglycemics overdose

Oral hypoglycemic pills are a class of prescription medications used to control diabetes. Oral means "taken by mouth." There are many different types of oral hypoglycemics. This article focuses on a class called sulfonylureas.

An overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

Alternative Names

Diabetes pill overdose; Sulfonylurea overdose

Poisonous Ingredient

There are many types of oral hypoglycemics. The poisonous ingredient depends on the specific drug. The main (active) ingredient in sulfonylurea-based oral hypoglycemics stimulates cells in the pancreas to produce more insulin.

Where Found

Sulfonylurea-based oral hypoglycemics are sold under a variety of brand names. Some are listed below.

  • Acetohexamide (Dymelor)
  • Chlorpropamide (Diabinese)
  • Glipizide (Glucotrol)
  • Glyburide (DiaBeta, Micronase)
  • Glimepiride (Amaryl)
  • Tolbutamide (Orinase)
  • Tolazamide (Tolinase)

Note: This list may not be all-inclusive.

Symptoms

Before Calling Emergency

Determine the following information:

  • Patient's age, weight, and condition
  • Name of the product (ingredients and strengths, if known)
  • Time it was swallowed
  • Amount swallowed

Poison Control

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

See: Poison control center - emergency number

What to Expect at the Emergency Room

The health care provider will measure and monitor your vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. You may receive:

  • Activated charcoal
  • Blood tests to measure blood glucose and electrolyte (body chemical) levels
  • EKG (heart tracing)
  • Fluids containing glucose (sugar)¬†through a vein (by IV)
  • Laxative
  • Tube through the nose into the stomach to empty the stomach (gastric lavage)

Outlook (Prognosis)

Some of these medications may stay in the body for a long time, so the person needs to be watched for several days. Permanent brain damage and death are possible, especially if an abnormal blood glucose level is not corrected in a timely manner.

References

Burns MJ, Levine M. Diabetic control agents. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Saunders Elsevier; 2007:chap 64.

Cydulka, RK, Maloney Jr GE. Diabetes Mellitus and Disorders of Glucose Homeostasis. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 126.

Updated: 1/18/2014

Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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