A 68-year-old woman on glibenclamide is brought to the emergency department with confusion and glucose of 38 mg/dL. She receives repeated boluses of 50% dextrose but hypoglycaemia recurs within two hours despite a continuing dextrose infusion. Which drug should be added to suppress ongoing insulin secretion?
- A Diazoxide
- B Hydrocortisone
- C Octreotide ✓
- D Glucagon
Correct answer: C. Octreotide
Explanation
Sulfonylureas bind SUR1 on beta cells and trigger insulin release independent of glucose. Somatostatin analogue octreotide inhibits this secretion and is the recommended adjunct when dextrose alone fails to sustain normoglycaemia. Glucagon only mobilises hepatic glycogen and offers transient rescue, while diazoxide opens KATP channels but is not standard emergency care here. Hydrocortisone has no role in drug induced hypoglycaemia.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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