Chlorpropamide, a first-generation sulfonylurea, is associated with a unique adverse effect not shared by newer sulfonylureas. Which effect is characteristic?
- A SIADH and hyponatremia ✓
- B Prolonged hypoglycemia
- C Weight gain
- D Hepatotoxicity
Correct answer: A. SIADH and hyponatremia
Explanation
Chlorpropamide uniquely causes SIADH (syndrome of inappropriate antidiuretic hormone secretion) leading to dilutional hyponatremia, an effect not seen with newer sulfonylureas. It also causes a disulfiram-like reaction with alcohol and has a longer half-life (24-48 hours), increasing hypoglycemia risk. These adverse effects have led to its near-complete replacement by newer agents.
Reference: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 14th ed.
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