Octreotide + Dextrose: Sulfonylurea poisoning

Figure show MOA of octreotide as sulfonylurea antidote.

• Newborns (4-8 ml/kg) D12.5W IV or IO.

• child D25W 2-4ml/kg IV or IO.

• D50 in adults at 1 ml/kg.

• Octreotide first-line therapy in both pediatric and adult sulfonylurea poisoning with clinical and laboratory evidence of hypoglycemia.

• octreotide in children is 1 – 2 mcg/kg up to 50 mcg SC or IV every 6-12 hours; in adults, octreotide 50 – 100 mcg SC or IV every 6-12 hours. The SC route is preferred. During this treatment IV dextrose infusion should be gradually tapered off.

• Remember to give food to your sulfonylurea ingestions (if awake and alert, no nausea or vomit and after GI decon). Hypoglycemic children will require dextrose infusions and octreotide.

  • Hypoglycemia can be delayed, so patients will need to be admitted at least 24 hours.

Ref:

http://www.emdocs.net/sulfonylurea-induced-hypoglycemia/

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