Home Drug Guide Chlorpropamide

Drug Guide

Generic Name

Chlorpropamide

Brand Names Diabinese, Glucamide

Classification

Therapeutic: Antidiabetic

Pharmacological: Sulfonylurea

FDA Approved Indications

  • Management of type 2 diabetes mellitus as an adjunct to diet and exercise

Mechanism of Action

Stimulates insulin secretion from pancreatic beta cells by closing ATP-sensitive potassium channels, leading to cell depolarization and increased insulin release.

Dosage and Administration

Adult: Initial dose: 250 mg once daily, adjusting based on response, up to a maximum of 500 mg per day in divided doses.

Pediatric: Not typically recommended for pediatric use due to limited data.

Geriatric: Start at lower dose due to increased risk of hypoglycemia and impaired renal function; monitor closely.

Renal Impairment: Use with caution; dose adjustments may be necessary. Renal function should be evaluated before and during therapy.

Hepatic Impairment: Use with caution; monitor for hypoglycemia as hepatic metabolism may be affected.

Pharmacokinetics

Absorption: Well absorbed from the gastrointestinal tract.

Distribution: Widely distributed; crosses the placenta and is excreted in breast milk.

Metabolism: Minimal hepatic metabolism.

Excretion: Primarily excreted unchanged by the kidneys.

Half Life: Approximately 36 hours, allowing once-daily dosing.

Contraindications

  • Known hypersensitivity to sulfonylureas or sulfonamides
  • Type 1 diabetes mellitus
  • Diabetic ketoacidosis
  • Severe hepatic impairment

Precautions

  • Use cautiously in elderly patients
  • History of hypoglycemia
  • Impaired renal or hepatic function
  • Pregnancy: Use only if clearly needed; monitor fetal well-being.
  • Lactation: Caution advised; small amounts may pass into breast milk.

Adverse Reactions - Common

  • Hypoglycemia (Common)
  • Nausea (Less common)
  • Dizziness (Less common)

Adverse Reactions - Serious

  • Severe hypoglycemia (Rare)
  • Blood dyscrasias (Rare)
  • Disulfiram-like reaction with alcohol (Rare)

Drug-Drug Interactions

  • Other antidiabetics (increased hypoglycemia risk)
  • CNS depressants (additive sedative effects)
  • NSAIDs (may alter renal function)

Drug-Food Interactions

  • Alcohol (increases hypoglycemia risk and disulfiram-like reaction)

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose regularly; assess for signs of hypoglycemia.

Diagnoses:

  • Risk for hypoglycemia
  • Ineffective tissue perfusion

Implementation: Administer as prescribed, preferably before meals; educate patient on hypoglycemia recognition.

Evaluation: Effective blood glucose control; absence of hypoglycemic episodes.

Patient/Family Teaching

  • Take medication exactly as prescribed at the same time each day.
  • Recognize symptoms of hypoglycemia and how to treat them.
  • Maintain regular dietary and exercise habits.
  • Avoid alcohol consumption while on this medication.
  • Report any signs of allergic reactions or unusual symptoms.

Special Considerations

Black Box Warnings: N/A

Genetic Factors: None specifically identified.

Lab Test Interference: May cause false-positive glucose in urine tests.

Overdose Management

Signs/Symptoms: Severe hypoglycemia with sweating, weakness, confusion, seizures, or coma.

Treatment: Administer glucose orally if conscious; intravenous dextrose for severe cases; monitor closely.

Storage and Handling

Storage: Store at room temperature away from moisture and light.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.