Antihyperglycemic OD
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þ Etiology and Dosage
 - a single pill can be dangerous or fatal
 - sulfonylurea receptors cause Ca++ influx and insulin efflux

þ onset
 - usually within 8 hours
 - peak plasma 1-8 hours
 - effects may last for days

þ Effects
 - standard hypoglycemic symptoms
 - may have focal neuro signs
 - some may not have tachycardia and diaphoresis, especially in kids

þ Treatment
 - allow child to eat
 - watch for signs of CNS changes
 - observe 6-8 hours (or better 24 hours) based on poison control center data
 - diazoxide:  antagonies sulfonylurea channel, but doesn't work well.
 - octreotide
   <Octreo.TXT>
  + long-acting somatostatin analogue