A 24-year-old woman is brought to the emergency department with repeated episodes of hypoglycemia after ingesting her grandmother's glibenclamide tablets. She receives IV dextrose but hypoglycemia recurs over several hours. The most appropriate additional therapy is:

• A Naloxone infusion
• B Diazoxide orally
• C Hydrocortisone IV
• D Octreotide subcutaneously ✓

Explanation

Glibenclamide has a long half-life and enterohepatic recirculation, so hypoglycemia recurs despite dextrose boluses. Octreotide, a somatostatin analog, suppresses insulin secretion and is the standard adjunct in sulfonylurea poisoning. Diazoxide opens KATP channels and is used for hyperinsulinemic hypoglycemia of infancy, not sulfonylurea overdose. Hydrocortisone and naloxone have no role here.

Reference: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.