Generic Name

Chlorpropamide

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Classification

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

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.