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Inadequate adrenergic response to disopyramide-induced hypoglycemia
R C Smith1, M Sullivan, J Geller
1University of Southern California, San Diego.
The Annals of Pharmacotherapy
|April 1, 1992
Summary
Disopyramide can cause dangerous hypoglycemia due to insulin secretion and a poor adrenergic response. Patients at risk require careful monitoring and dose adjustment or alternative medications.
Area of Science:
- Clinical Pharmacology
- Endocrinology
Background:
- Drug-induced hypoglycemia is a known adverse effect of various medications.
- Disopyramide is an antiarrhythmic drug with reported associations with hypoglycemia, though the mechanism remains unclear.
Observation:
- A case of disopyramide-induced hypoglycemia was investigated.
- Measurements included counter-regulatory hormones, serum insulin, and C-peptide levels.
Findings:
- Disopyramide-induced hypoglycemia appears to stem from endogenous insulin secretion.
- This is accompanied by an inadequate counterregulatory hormonal response.
Implications:
- Disopyramide-induced hypoglycemia is rare but potentially life-threatening.
- Identifying at-risk patients before therapy is crucial.
- Monitoring and maintaining low therapeutic disopyramide concentrations or considering alternatives is recommended for at-risk individuals.