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Distinguishing characteristics of exposure to biguanide and sulfonylurea anti-diabetic medications in the United States.
Mehrpour, Omid; Saeedi, Farhad; Hoyte, Christopher; Hadianfar, Ali; Nakhaee, Samaneh; Brent, Jeffrey.
Afiliación
  • Mehrpour O; Data Science Institute, Southern Methodist University, Dallas, TX, USA. Electronic address: omehrpour@smu.edu.
  • Saeedi F; Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran; Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran.
  • Hoyte C; University of Colorado, Anschutz Medical Campus, Aurora, CO, USA; University of Colorado Hospital, Aurora, CO, USA.
  • Hadianfar A; Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Nakhaee S; Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran.
  • Brent J; School of Medicine, University of Colorado, Aurora, CO, USA.
Am J Emerg Med ; 56: 171-177, 2022 06.
Article en En | MEDLINE | ID: mdl-35398707
OBJECTIVES: Biguanides and sulfonylureas are anti-hyperglycemic drugs commonly used in the United States. Poisoning with these drugs may lead to serious consequences. The diagnosis of biguanide and sulfonylurea poisoning is based on history, clinical manifestations, and laboratory studies. METHODS: This study is a six-year retrospective cohort analysis based on the National Poison Data System. Clinical effects of 6183 biguanide and sulfonylurea exposures were identified using binary logistic regression. RESULTS: The mean age of patients with biguanide and sulfonylurea exposure was 39.27 ± 28.91 and 28.91 ± 30.41 years, respectively. Sulfonylurea exposure is most commonly seen via unintentional exposure, while biguanide exposure frequently occurs as a result of intentional ingestion. Minor and moderate outcomes commonly developed following biguanide and sulfonylurea exposure, respectively. Sulfonylurea exposure was less likely to develop clinical effects abdominal pain, metabolic acidosis, diarrhea, nausea, vomiting, and elevated creatinine than patients ingesting biguanides. However, sulfonylurea exposure was more likely to cause dizziness or vertigo, tremor, drowsiness or lethargy, agitation, diaphoresis, and hypoglycemia. CONCLUSIONS: Our study is the first to use a wide range of national data to describe the clinical characteristics that differentiate the toxicologic exposure to biguanides and sulfonylureas. Sulfonylurea exposure is commonly seen via unintentional exposure, while metformin exposure is frequently seen via intentional exposure. Sulfonylurea toxicity is more likely to cause agitation, dizziness or vertigo, tremor, diaphoresis, and hypoglycemia, while metformin exposure induces abdominal pain, acidosis, diarrhea, nausea, vomiting, and elevated creatinine.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Acidosis / Diabetes Mellitus / Hipoglucemia / Metformina Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Child / Humans / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Am J Emerg Med Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Acidosis / Diabetes Mellitus / Hipoglucemia / Metformina Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Child / Humans / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Am J Emerg Med Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos