| Severe and protracted hypoglycaemia associated with co-trimoxazole use. | |
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MedLine Citation:
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PMID: 16500599 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Co-trimoxazole (trimethoprim-sulfamethoxazole) is a commonly prescribed antimicrobial agent. Although it is well tolerated in most patients, serious adverse events related to its use have been described. Hypoglycaemia is a rare but potentially life-threatening complication of therapy. We describe a case of refractory hypoglycaemia complicated by seizure associated with co-trimoxazole for the treatment of Pneumocystis carinii pneumonia in a patient with AIDS. We also review 13 previously reported cases of co-trimoxazole-induced hypoglycaemia. Among this patient population, renal insufficiency was the most prevalent predisposing risk factor (93%). The mean daily dose of co-trimoxazole was 4.5 double strength (160 mg trimethoprim/800 mg sulfamethoxazole) tablets per day. Serum insulin levels were raised or inappropriately normal in 88% of cases in which they were measured, suggesting a sulfonylurea-like effect of co-trimoxazole as the mechanism of hypoglycaemia. All cases required intravenous glucose administration, and 43% experienced protracted (>12 hours) hypoglycaemia. Dosage adjustments should be made when prescribing co-trimoxazole to patients with renal dysfunction. |
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Authors:
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Elizabeth L Strevel; Ayelet Kuper; Wayne L Gold |
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Publication Detail:
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Type: Case Reports; Clinical Conference; Journal Article |
Journal Detail:
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Title: The Lancet infectious diseases Volume: 6 ISSN: 1473-3099 ISO Abbreviation: Lancet Infect Dis Publication Date: 2006 Mar |
Date Detail:
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Created Date: 2006-02-27 Completed Date: 2006-04-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101130150 Medline TA: Lancet Infect Dis Country: United States |
Other Details:
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Languages: eng Pagination: 178-82 Citation Subset: IM |
Affiliation:
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University of Toronto, Toronto, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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AIDS-Related Opportunistic Infections
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drug therapy* Adult Aged Aged, 80 and over Antifungal Agents / administration & dosage, adverse effects*, pharmacology Female Glucose / administration & dosage Humans Hypoglycemia / chemically induced* Infant Insulin / blood Male Middle Aged Pneumonia, Pneumocystis / drug therapy* Risk Factors Seizures / etiology Trimethoprim-Sulfamethoxazole Combination / administration & dosage, adverse effects*, pharmacology |
| Chemical | |
Reg. No./Substance:
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0/Antifungal Agents; 11061-68-0/Insulin; 50-99-7/Glucose; 8064-90-2/Trimethoprim-Sulfamethoxazole Combination |
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