A 76-year-old woman with type 2 diabetes is brought to the hospital after her family discovered her unresponsive in the morning. Her daughter reports that they had a full day of activities that required a lot of walking the day before. Because she was tired, the patient ate less dinner than usual. She had previously discontinued several diabetes medications due to medication intolerance, but has recently had good glycemic control with a single medication. The blood pressure is 140/80 mm Hg, and the pulse rate is 102/min. The patient is diaphoretic and only reacts to pain. Pupils are equal, round, and light reactive. The cardiopulmonary exam is normal. The blood glucose level is 34 mg/dL. Following the administration of an intravenous bolus of dextrose, the patient's condition rapidly improves. but she becomes confused again several hours later. Repeat blood glucose is 39 mg/dL. Which of the following medications is the most likely cause of this patient's current condition?

Question

A 76-year-old woman with type 2 diabetes is brought to the hospital after her family discovered her unresponsive in the morning. Her daughter reports that they had a full day of activities that required a lot of walking the day before. Because she was tired, the patient ate less dinner than usual. She had previously discontinued several diabetes medications due to medication intolerance, but has recently had good glycemic control with a single medication. The blood pressure is 140/80 mm Hg, and the pulse rate is 102/min. The patient is diaphoretic and only reacts to pain. Pupils are equal, round, and light reactive. The cardiopulmonary exam is normal. The blood glucose level is 34 mg/dL. Following the administration of an intravenous bolus of dextrose, the patient's condition rapidly improves. but she becomes confused again several hours later.  Repeat blood glucose is 39 mg/dL.  Which of the following medications is the most likely cause of this patient's current condition?

Quizplus · Accepted Answer

Eductional Objective: Sulfonylureas (such as glyburide and glimepiride) increase insulin secretion by pancreatic beta cells regardless of blood glucose levels. Hypoglycemia is common with these medications, especially in the elderly.

A 76-Year-Old Woman with Type 2 Diabetes Is Brought to the Hospital