Antidiabetic Medications: Hypoglycemic Potential in Overdose

antidiabetic medicationsWith several new diabetes medications available, it is important to know which ones are likely to cause hypoglycemia after overdose. Based on mechanism of action and reported cases, the likelihood of hypoglycemia after overdose is listed below by drug class.

Keep in mind that other drugs can interact with antidiabetic medications resulting in hypoglycemia. The following table applies only to single agent ingestion/administration.

Drug Class
Examples
Hypoglycemic Potential
InsulinsGlargine, Aspart, DetemirHigh
SulfonylureasGlyburide, Glipizide, GlimepirideHigh
MeglitinidesNateglinide, RepaglinideHigh
Glucagon-Like Peptide-1 (GLP-1) Receptor AgonistsExenatide, Albiglutide, LiraglutideLow-Moderate
Alpha-glucosidase inhibitorsAcarbose, MiglitolLow
ThiazolidinedionesRosiglitazone, PiaglitazoneLow
BiguanidesMetforminLow
Dipeptidyl Peptidase 4 (DPP-4) InhibitorsSitagliptin, Saxagliptin, LinagliptinLow
Sodium-Glucose Cotransporter 2 (SGLT2) InhibitorsCanagliflozinLow

Adapted from a University of Maryland Emergency Medicine (UMEM, @UMEmergencyMed) educational pearl.

Reference

Bosse GM. Chapter 48. Antidiabetics and Hypoglycemics [Access Medicine link]. In: Bosse GM, ed. Goldfrank’s Toxicologic Emergencies. 9th ed. New York: McGraw-Hill; 2011. Accessed August 15, 2014.

Image credit

Author information

Bryan D. Hayes, PharmD, FAACT

Bryan D. Hayes, PharmD, FAACT

ALiEM Associate Editor

Clinical Assistant Professor, University of Maryland (UM)

Clinical Pharmacy Specialist, EM and Toxicology

The post Antidiabetic Medications: Hypoglycemic Potential in Overdose appeared first on ALiEM.

I am Amal Mattu, ECG nerd and author of Emergency ECG Video of the Week: How I Work Smarter

How I Work Smarter LogoAs this series has progress, we have received a multitude of nominations for call-outs. One of the most popular requests was to have Dr. Amal Mattu (@amalmattu) share his efficiency secrets. Amal has blanketed the world of continuing medical education with didactics and workshops on ECG interpretation and faculty development skills. He authors the extremely popular Emergency ECG Video of the Week series and hosts a monthly EMCast podcast for Emedhome.com. He also the Consulting Editor for Emergency Medicine Clinics of North America. He does it all. When I emailed requesting his insights, I was surprised to hear his response.

Mattu

Response from Dr. Amal Mattu

I’m the antithesis of the modern twitter/tech generation in terms of “working smart.” I don’t use Google Docs, Google Calendars, iCalendar, Dropbox, or any special technology. I don’t have any special method of organization except a folded piece of paper that I carry in my pocket and write notes on when something needs to be done… a paper to-do list. It’s just paper.

 

MattuToDo

 

Where I do most of my work

I do most of my work not in my study or office, but on our kitchen table when kids are at school or in bed. If something needs to be done by a deadline, I write down the deadline and just do it. If something doesn’t need to be done right away, I don’t do it right away. No fancy organization.

MattuOffice

 

My time

I make sure I spend time with the family and workout. I don’t watch much TV. I sleep 5-6 hours/night. When I travel, I work on the plane and in the hotel, I workout, eat room service, and get caught up on sleep.

I see lots of people spend hours and hours trying to get organized with different high-tech methods. I don’t worry about being organized… I just do what needs to be done in the order in which things need to be done. That’s really all I do.

Author information

Michelle Lin, MD

ALiEM Editor-in-Chief

Editorial Board Member, Annals of Emergency Medicine

UCSF Academy Endowed Chair for EM Education

UCSF Associate Professor of Emergency Medicine

San Francisco General Hospital

The post I am Amal Mattu, ECG nerd and author of Emergency ECG Video of the Week: How I Work Smarter appeared first on ALiEM.

I am Amal Mattu, ECG nerd and author of Emergency ECG Video of the Week: How I Work Smarter

How I Work Smarter LogoAs this series has progress, we have received a multitude of nominations for call-outs. One of the most popular requests was to have Dr. Amal Mattu (@amalmattu) share his efficiency secrets. Amal has blanketed the world of continuing medical education with didactics and workshops on ECG interpretation and faculty development skills. He authors the extremely popular Emergency ECG Video of the Week series and hosts a monthly EMCast podcast for Emedhome.com. He also the Consulting Editor for Emergency Medicine Clinics of North America. He does it all. When I emailed requesting his insights, I was surprised to hear his response.

Mattu

Response from Dr. Amal Mattu

I’m the antithesis of the modern twitter/tech generation in terms of “working smart.” I don’t use Google Docs, Google Calendars, iCalendar, Dropbox, or any special technology. I don’t have any special method of organization except a folded piece of paper that I carry in my pocket and write notes on when something needs to be done… a paper to-do list. It’s just paper.

 

MattuToDo

 

Where I do most of my work

I do most of my work not in my study or office, but on our kitchen table when kids are at school or in bed. If something needs to be done by a deadline, I write down the deadline and just do it. If something doesn’t need to be done right away, I don’t do it right away. No fancy organization.

MattuOffice

 

My time

I make sure I spend time with the family and workout. I don’t watch much TV. I sleep 5-6 hours/night. When I travel, I work on the plane and in the hotel, I workout, eat room service, and get caught up on sleep.

I see lots of people spend hours and hours trying to get organized with different high-tech methods. I don’t worry about being organized… I just do what needs to be done in the order in which things need to be done. That’s really all I do.

Author information

Michelle Lin, MD

ALiEM Editor-in-Chief

Editorial Board Member, Annals of Emergency Medicine

UCSF Academy Endowed Chair for EM Education

UCSF Associate Professor of Emergency Medicine

San Francisco General Hospital

The post I am Amal Mattu, ECG nerd and author of Emergency ECG Video of the Week: How I Work Smarter appeared first on ALiEM.

PV Card: Focused Abdominal Aorta Ultrasound

Abdominal Aorta UltrasoundIn this next ultrasound installment in the PV Card series, Drs. Victoria Koskenoja, Heidi Kimberly, and Mike Stone succinctly summarize the focused abdominal aorta ultrasound to assess for an abdominal aortic aneurysm (AAA). These can serve as key reference cards when you do your next AAA scan. Don’t miss the last card with tips on optimizing the view and common pitfalls.

 

PV Card: Focused Abdominal Aorta Ultrasound

Ultrasound Abdominal Aorta 1 PV

 

Ultrasound Abdominal Aorta 2 PV

Ultrasound Abdominal Aorta 3 PV

Ultrasound Abdominal Aorta 4 PV

You can download this PV card:  [MS Word] [PDF]

Author information

Michelle Lin, MD

ALiEM Editor-in-Chief

Editorial Board Member, Annals of Emergency Medicine

UCSF Academy Endowed Chair for EM Education

UCSF Associate Professor of Emergency Medicine

San Francisco General Hospital

The post PV Card: Focused Abdominal Aorta Ultrasound appeared first on ALiEM.

PV Card: Focused Abdominal Aorta Ultrasound

Abdominal Aorta UltrasoundIn this next ultrasound installment in the PV Card series, Drs. Victoria Koskenoja, Heidi Kimberly, and Mike Stone succinctly summarize the focused abdominal aorta ultrasound to assess for an abdominal aortic aneurysm (AAA). These can serve as key reference cards when you do your next AAA scan. Don’t miss the last card with tips on optimizing the view and common pitfalls.

 

PV Card: Focused Abdominal Aorta Ultrasound

Ultrasound Abdominal Aorta 1 PV

 

Ultrasound Abdominal Aorta 2 PV

Ultrasound Abdominal Aorta 3 PV

Ultrasound Abdominal Aorta 4 PV

You can download this PV card:  [MS Word] [PDF]

Author information

Michelle Lin, MD

ALiEM Editor-in-Chief

Editorial Board Member, Annals of Emergency Medicine

UCSF Academy Endowed Chair for EM Education

UCSF Associate Professor of Emergency Medicine

San Francisco General Hospital

The post PV Card: Focused Abdominal Aorta Ultrasound appeared first on ALiEM.

PV Card: FAST Ultrasound

FAST UltrasoundKeeping in line with the recent ultrasound posts this month, Dr. Mike Stone’s star team is releasing a series of Paucis Verbis cards on the basics of bedside ultrasonography. Here is the first in the series on the Focused Assessment with Sonography in Trauma (FAST) by Drs. Wilma Chan, John Eicken, and Mike Stone.


PV Card: FAST Ultrasound

Ultrasound FAST 1 PV

Ultrasound FAST 2 PV

Ultrasound FAST 3 PV

Ultrasound FAST 4 PV

 

You can download this PV card:  [MS Word] [PDF]

Author information

Michelle Lin, MD

ALiEM Editor-in-Chief

Editorial Board Member, Annals of Emergency Medicine

UCSF Academy Endowed Chair for EM Education

UCSF Associate Professor of Emergency Medicine

San Francisco General Hospital

The post PV Card: FAST Ultrasound appeared first on ALiEM.