UMEM Educational Pearls

Category: Toxicology

Title: Octreotide - The Antidote for Sulfonylurea Toxicity

Keywords: octreotide, sulfonylurea, hypoglycemia (PubMed Search)

Posted: 1/22/2009 by Fermin Barrueto, MD (Updated: 12/7/2019)
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Octreotide

  • Somatostatin-analog that supresses insulin secretion but also treats acromegaly, esophageal varices and secretory diarrhea
  • Sulfonylurea-induced hypoglycemia requires frequent monitoring and administration of intravenous dextrose
  • Octreotide is considered antidotal therapy since it turns off insulin secretion that is caused by sulfonylureas
  • Recent article by Fasano et al Ann Emerg Med 2008 showed that octreotide 75 mcg SQ one-time in the ED was superior to "traditional" therapy with fewer recurrent hypoglycemic episodes during the patient's hospitalization.
  • Excellent article worth reading, even if its just the abstract

References

Fasano CJ, O'Malley G, Dominici P, Aguilera E, Latta DR. Comparison of octreotide and standard therapy versus standard therapy alone for the treatment of sulfonylurea-induced hypoglycemia. Ann Emerg Med. 2008 Apr;51(4):400-6. Epub 2007 Aug 30.