Oral Hypoglycemic Agent Toxicity Workup

Updated: Jan 15, 2020
  • Author: David Tran, MD; Chief Editor: Stephen L Thornton, MD  more...
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Workup

Laboratory Studies

Most hospitals do not have the capability to analyze for levels of sulfonylureas and/or their metabolites. Even if it is possible to obtain these levels, no data indicate they should be used in the clinical setting. Tests for oral hypoglycemic agent exposure may include the following:

  • Fingerstick and/or serum glucose test to detect hypoglycemia (If hypoglycemia does not occur within the first 2-4 hours after suspected ingestion/overdose, then other laboratory tests are unnecessary.)

  • Baseline complete blood cell (CBC) count  (in symptomatic patients)

  • Baseline electrolytes, especially potassium (in symptomatic patients)

  • Serum aspirin and acetaminophen concentrations, and urine toxicological screening, if intentional ingestion/suicide attempt is suspected

  • Pregnancy test, if indicated

  • Ethanol level, if indicated

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Imaging Studies

Head computed tomographic scanning without, and then with, intravenous contrast is recommended in patients with any of the following:

  • Altered mental status
  • Focal neurologic deficit
  • New-onset seizures
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Other Tests

Electrocardiography (ECG) is recommended in patients with a suspected history of tricyclic antidepressant toxicity or in those with severe electrolyte abnormalities.

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