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Evidence-based medicine, rational use of
Glibenclamide is a sulfonylurea-based blood sugar-lowering drug and is an insulin secretion promoter. Glibenclamide is used to control mild and moderate type 2 diabetes with unsatisfactory efficacy of diet alone. The patients' pancreatic β cells have a certain secretion of insulin and , and there are no serious complications [1-3].
What should be paid attention to in clinical applications of glibenclamide? Today, Jie Xiaoyao tells you.
G6PD deficiency patients use with caution!
Treatment of glucose 6-phosphate dehydrogenase (G6PD) deficiency patients with sulfonylureas can lead to hemolytic anemia . Since glibenclamide is a sulfonylurea drug, it should be used with caution in patients with G6PD deficiency and alternatives to non-sulfonylurea drugs should be considered. In post-marketing reports, hemolytic anemia has also been reported in patients with unknown G6PD deficiency.
Which people should be alert to the occurrence of severe hypoglycemia?
All sulfonylurea drugs can produce severe hypoglycemia symptoms. Correct patient selection and dosage instructions are important to avoid the onset of hypoglycemia. Renal insufficiency or liver insufficiency may lead to increased drug levels of glibenclamide, which may also reduce the ability of gluconeogenesis , both of which increase the risk of severe hypoglycemia.
The elderly, weak or malnutritional patients, and adrenal or pituitary insufficiency patients are particularly susceptible to the hypoglycemic effects of hypoglycemic drugs. Symptoms of hypoglycemia may be difficult to identify in older people and people taking beta-adrenergic blocking drugs.
Hypoglycemia is more likely to occur when calorie intake is insufficient, after vigorous or long-term exercise, intake of alcohol or combined with more than one hypoglycemia-lowering drugs. Combination therapy may increase the risk of hypoglycemia.
How to deal with overdose of drugs [4-5]?
▌ overdose manifests
sulfonylurea drugs overdose (including glibenclave tablets), which can produce hypoglycemia.
▌ treatment plan
mild hypoglycemia symptoms, no loss of consciousness or nervous system manifestations, should be actively treated by oral glucose and adjusting drug dosage and/or adjusting dietary patterns. Monitoring should be continued until the doctor is convinced that the patient is out of danger. Severe hypoglycemia reactions accompanied by coma, seizures or other neurological disorders rarely occur and require immediate hospitalization for treatment once it occurs.
If hypoglycemia coma is diagnosed or suspected, the patient should be given a rapid intravenous injection of concentrated (50%) glucose solution, and then the dilute (10%) glucose solution should be continuously injected at the rate of maintaining blood sugar above 100 mg/dL. Patients should be closely monitored for at least 24-48 hours, as hypoglycemia may occur again after significant clinical recovery.
More popular medicines in the department, where to learn?
If you have just entered the department, where can you read the commonly used drugs in the department? What conditions dosage adjustments need? Should I double the first time I use it? solvent is salt or sugar
As a veteran in the department, what are the differences between injections and tablets? What are the usages abroad that can be learned from? How to deal with overdoses? When facing new students who have entered the subject, how can I gracefully throw a link to let Xiaobai learn medicine knowledge?
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References:
[1]Drug information: Glibenpress Tablets, Sinopharm Group Shantou Jinshi Pharmaceutical Co., Ltd., National Drug Profile H44021065.
[2] Drug information: Glibenpress tablets, Zhejiang Nanyang Pharmaceutical Co., Ltd., National Drug Approval H33021087; 2010/06/03.
[3] Drug information: Glibenclamide Capsules, Guangdong Longxin Pharmaceutical Co., Ltd., National Drug Approval H20010068.
[4]Product Information:GLYBURIDE tablet,AvKARE,Updated January 13,2022.
[5]Product Information:GLYNASE-glyburide tablet,Pharmacia and Upjohn Company LLC,Updated October 7,2017.
