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chlorpropamide (Diabinese)
Tradename: Diabinese. 1st generation sulfonylurea.
Dosage: start with 100-250 mg PO QD, max 750 mg/day.
Tabs: 100 & 250 mg.
Pharmacokinetics:
-> no significant metabolism
Adverse effects:
1) hematologic:
-> transient leukopenia, thrombocytopenia, hemolytic anemia, pancytopenia, eosinophilia
2) gastrointestinal disturbances
3) headache
4) tinnitus
5) photosensitivity
6) allergic skin reactions
7) intolerance to alcohol
8) most serious adverse effects
a) hypoglycemia
b) hepatic dysfunction
9) SIADH (only hypoglycemic to cause SIADH)
Drug interactions:
-> increased risk of hypoglycemia with:
-> sulfonamides, non-selective beta-blockers (propranolol), salicylates, clofibrate, phenylbutazone, probenecid, dicumarol, warfarin, chloramphenicol, MAO inhibitors, alcohol
Laboratory:
1) specimen: serum
2) methods: HPLC, GLC, color
3) interferences:
a) color: hemolysis, primary & secondary amines
b) GLC: plasma lipids
Interactions
drug interactions
drug adverse effects (more general classes)
monitor with sulfonylureas
General
sulfonylurea
Properties
MISC-INFO: elimination route KIDNEY
1/2life 36 HOURS
therapeutic-range 75-250 UG/ML
toxic-range >200 NG/ML
protein-binding 60-95%
elimination by peritoneal dialysis -
pregnancy-category C
safety in lactation -
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Clinical Guide to Laboratory Tests, 3rd edition, NW Tietz
ed, WB Saunders, Philadelphia, 1995
- Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed.,
W.B. Saunders, 1995