| Trimethoprim-sulfamethoxazole-associated severe hypoglycaemia: a sulfonylurea-like effect. | |
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MedLine Citation:
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PMID: 21375132 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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AIM: To report hypoglycaemia, a life-threatening adverse event, associated with trimethoprim-sulfamethoxazole. A sulfonylurea-like effect, leading to insulin raise, was investigated. METHODS: Two cases of trimethoprim-sulfamethoxazole-associated hypoglycaemia in 2 patients with a diagnosis of new HIV-1-infection presenting with Pneumocystis jiroveci pneumonia are reported. The patients had no predisposing factors, such as renal or liver impairment, interfering with trimethoprim-sulfamethoxazole elimination, thus leading to hypoglycaemia. Insulin plasma levels were measured in both patients. RESULTS: Severe hypoglycaemia was associated with increased serum levels of insulin up to 84 microU/ml (normal values < 10 microU/ml). Continuous dextrose infusion was necessary, further suggesting the sulfonylurea-like effect of sulfamethoxazole. Interestingly, plasma levels of insulin progressively raised after trimethoprim-sulfamethoxazole administration. CONCLUSIONS: Only 18 cases of trimethoprim-sulfamethoxazole associated hypoglycaemia are reported in the literature. Hypoglycaemia is a life-threatening condition, likely underreported, to consider when trimethoprim-sulfamethoxazole administration is required, even in the absence of predisposing factors or other hypoglycaemic agents. Physician should bear in mind the potential trimethoprim-sulfamethoxazole-associated adverse event especially when prolonged treatments and elevated dosage are used. |
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Authors:
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G Nunnari; B M Celesia; F Bellissimo; S Tosto; M La Rocca; F Giarratana; F Benanti; E Caltabiano; R Russo; B Cacopardo |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European review for medical and pharmacological sciences Volume: 14 ISSN: 1128-3602 ISO Abbreviation: Eur Rev Med Pharmacol Sci Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2011-03-07 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9717360 Medline TA: Eur Rev Med Pharmacol Sci Country: Italy |
Other Details:
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Languages: eng Pagination: 1015-8 Citation Subset: IM |
Affiliation:
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Department of Medicine, Unit of Infectious Diseases, ARNAS Garibaldi, University of Catania, Catania, Italy. gnunnari@hotmail.com |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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