Related Experiment Videos
Sulfonamide-induced hypoglycemia in chronic renal failure
Archives of Internal Medicine
|April 1, 1983
Summary
Sulfamethoxazole-trimethoprim can cause severe hypoglycemia in patients with chronic renal failure due to hyperinsulinemia. Discontinuation of the antibiotic resolved the condition, highlighting a critical drug interaction.
Area of Science:
- Pharmacology
- Nephrology
- Endocrinology
Background:
- Chronic renal failure (CRF) poses challenges in drug management.
- Urinary tract infections (UTIs) are common in patients with CRF.
- Sulfonamides are frequently used for UTIs.
Observation:
- A patient with CRF developed severe hypoglycemia while on sulfamethoxazole-trimethoprim therapy.
- The hypoglycemia was characterized by elevated insulin levels.
- Symptoms resolved upon drug discontinuation and intravenous glucose administration.
Findings:
- Rechallenge with sulfamethoxazole-trimethoprim confirmed the link to hyperinsulinemia and hypoglycemia.
- The patient experienced hypoglycemia during a 48-hour fast while on the drug, resolving after discontinuation.
- Factors like congestive heart failure, growth hormone deficiency, and hypoalaninemia may have contributed.
Implications:
- Sulfamethoxazole-trimethoprim should be used cautiously in patients with CRF.
- Healthcare providers should monitor for hypoglycemia in patients with CRF on sulfonamides.
- This case underscores the importance of considering drug-induced hypoglycemia in complex patient populations.