PDF(Pubmed)
Abstract：
UNASSIGNED: Because of their similar appearance and inexpensive cost, sulfonylureas can cause hypoglycemia when substituted for benzodiazepines by the illicit drug market. We present a patient who developed hypoglycemia after ingestion of what she thought to be Valium; work-up revealed sulfonylurea exposure.
UNASSIGNED: A 33-year-old patient was brought to the hospital after being found unresponsive by paramedics with a reported venous blood glucose level of 18 mg/dL (reference range, 70-140 mg/dL). This prompted treatment with 12.5 g of dextrose administered intravenously. At the hospital, the venous blood glucose level was 15 mg/dL resulting in intravenous dextrose infusion initiation. Once stable, the patient endorsed a medical history of substance use disorder and anxiety. She reported ingesting 2 blue pills given to her by a friend as Valium for her anxiety. Laboratory values showed an elevated insulin level of 47.4 mIU/mL (2.6-24.9), an elevated C-peptide level of 5.4 ng/mL (1.1-4.4), and a glucose level of 44 mg/dL (>70 mg/dL). The patient underwent a 72-hour fasting test. Blood hypoglycemia agent screening showed positive results for glyburide (>5 ng/mL). The patient was discharged home in stable condition.
UNASSIGNED: There are approximately 2 to 5 case reports of hypoglycemia among persons taking illicit drugs containing sulfonylureas. Laboratory values consistent with the use of a hypoglycemic agent include elevated insulin and C-peptide levels, a low glucose level, and positive results for hypoglycemia agent screening.
UNASSIGNED: Sulfonylurea-induced hypoglycemia may lead to clinical sedation, mimicking the effects of benzodiazepines. Sulfonylurea substitution or drug contamination should be suspected when severe hypoglycemia is diagnosed in unresponsive patients suspected of taking illicit drugs.
UNASSIGNED: A 33-year-old patient was brought to the hospital after being found unresponsive by paramedics with a reported venous blood glucose level of 18 mg/dL (reference range, 70-140 mg/dL). This prompted treatment with 12.5 g of dextrose administered intravenously. At the hospital, the venous blood glucose level was 15 mg/dL resulting in intravenous dextrose infusion initiation. Once stable, the patient endorsed a medical history of substance use disorder and anxiety. She reported ingesting 2 blue pills given to her by a friend as Valium for her anxiety. Laboratory values showed an elevated insulin level of 47.4 mIU/mL (2.6-24.9), an elevated C-peptide level of 5.4 ng/mL (1.1-4.4), and a glucose level of 44 mg/dL (>70 mg/dL). The patient underwent a 72-hour fasting test. Blood hypoglycemia agent screening showed positive results for glyburide (>5 ng/mL). The patient was discharged home in stable condition.
UNASSIGNED: There are approximately 2 to 5 case reports of hypoglycemia among persons taking illicit drugs containing sulfonylureas. Laboratory values consistent with the use of a hypoglycemic agent include elevated insulin and C-peptide levels, a low glucose level, and positive results for hypoglycemia agent screening.
UNASSIGNED: Sulfonylurea-induced hypoglycemia may lead to clinical sedation, mimicking the effects of benzodiazepines. Sulfonylurea substitution or drug contamination should be suspected when severe hypoglycemia is diagnosed in unresponsive patients suspected of taking illicit drugs.
摘要：
■由于它们的外观相似且价格低廉，当非法药物市场取代苯二氮卓类药物时，磺酰脲类会导致低血糖。我们介绍了一名患者，该患者在摄入她认为是安定的东西后出现低血糖；检查显示磺酰脲类药物暴露。
■一名33岁的患者在被护理人员发现无反应后被送往医院，报告的静脉血糖水平为18mg/dL（参考范围，70-140毫克/分升)。这提示了静脉内施用12.5g右旋糖的治疗。在医院,静脉血糖水平为15mg/dL,导致开始静脉输注葡萄糖.一旦稳定,患者有药物使用障碍和焦虑病史.她报告说，由于焦虑，她摄入了朋友给她的2颗蓝色药丸作为安定。实验室值显示胰岛素水平升高47.4mIU/mL（2.6-24.9），升高的C肽水平为5.4ng/mL（1.1-4.4），和44mg/dL(>70mg/dL)的葡萄糖水平。患者接受72小时空腹测试。血液低血糖剂筛查显示格列本脲阳性结果(>5ng/mL)。患者出院，情况稳定。
■在服用含有磺酰脲类违禁药物的患者中，大约有2至5例低血糖报告。与使用降血糖药一致的实验室值包括胰岛素和C肽水平升高，低葡萄糖水平,和低血糖药物筛查的阳性结果。
■磺酰脲引起的低血糖可能导致临床镇静，模仿苯二氮卓类药物的作用。当在怀疑服用非法药物的无反应患者中诊断出严重的低血糖时，应怀疑磺酰脲替代或药物污染。
■一名33岁的患者在被护理人员发现无反应后被送往医院，报告的静脉血糖水平为18mg/dL（参考范围，70-140毫克/分升)。这提示了静脉内施用12.5g右旋糖的治疗。在医院,静脉血糖水平为15mg/dL,导致开始静脉输注葡萄糖.一旦稳定,患者有药物使用障碍和焦虑病史.她报告说，由于焦虑，她摄入了朋友给她的2颗蓝色药丸作为安定。实验室值显示胰岛素水平升高47.4mIU/mL（2.6-24.9），升高的C肽水平为5.4ng/mL（1.1-4.4），和44mg/dL(>70mg/dL)的葡萄糖水平。患者接受72小时空腹测试。血液低血糖剂筛查显示格列本脲阳性结果(>5ng/mL)。患者出院，情况稳定。
■在服用含有磺酰脲类违禁药物的患者中，大约有2至5例低血糖报告。与使用降血糖药一致的实验室值包括胰岛素和C肽水平升高，低葡萄糖水平,和低血糖药物筛查的阳性结果。
■磺酰脲引起的低血糖可能导致临床镇静，模仿苯二氮卓类药物的作用。当在怀疑服用非法药物的无反应患者中诊断出严重的低血糖时，应怀疑磺酰脲替代或药物污染。
