Home Drug Guide Tolazamide

Drug Guide

Generic Name

Tolazamide

Brand Names Tolinase

Classification

Therapeutic: Antidiabetic agent

Pharmacological: Sulfonylurea

FDA Approved Indications

  • Management of non-insulin-dependent (type 2) diabetes mellitus

Mechanism of Action

Stimulates insulin release from pancreatic beta cells, thereby lowering blood glucose levels.

Dosage and Administration

Adult: Initial dose usually 100-250 mg once daily, adjusted based on response. Maintenance doses typically 100-300 mg daily in divided doses

Pediatric: Not recommended for pediatric use

Geriatric: Use with caution; start at lower doses due to increased prevalence of renal, hepatic, or cardiac impairment

Renal Impairment: Adjust doses based on renal function; monitor renal status

Hepatic Impairment: Use with caution; hepatic function should be evaluated before initiation and periodically thereafter.

Pharmacokinetics

Absorption: Well absorbed from gastrointestinal tract

Distribution: Distributed widely in body tissues and fluids

Metabolism: Partially metabolized in the liver

Excretion: Primarily excreted via urine

Half Life: Approximately 4-8 hours

Contraindications

  • Hypersensitivity to tolazamide or other sulfonylureas
  • Diabetic ketoacidosis

Precautions

  • Use with caution in patients with hepatic or renal impairment, adrenal or pituitary insufficiency, or sulfonamide allergy; risk of hypoglycemia, especially in elderly.

Adverse Reactions - Common

  • Hypoglycemia (Common)
  • Gastrointestinal upset (Less common)

Adverse Reactions - Serious

  • Hypersensitivity reactions (Rare)
  • Blood dyscrasias (Rare)
  • Jaundice or hepatic dysfunction (Rare)

Drug-Drug Interactions

  • Other antidiabetic agents, especially insulin or other sulfonylureas; beta-blockers (may mask hypoglycemia symptoms); NSAIDs (may enhance hypoglycemic effect).

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose levels regularly; assess for signs of hypoglycemia and hepatic dysfunction.

Diagnoses:

  • Risk for hypoglycemia
  • Impaired skin integrity related to hypersensitivity reactions

Implementation: Administer as prescribed; educate about signs of hypoglycemia; caution regarding alcohol consumption.

Evaluation: Blood glucose control and absence of adverse effects.

Patient/Family Teaching

  • Take medication regularly and as prescribed.
  • Recognize symptoms of hypoglycemia and how to treat it.
  • Maintain a balanced diet and consistent carbohydrate intake.
  • Avoid alcohol and inform healthcare provider of any side effects.

Special Considerations

Black Box Warnings:

  • Serious hypoglycemia can occur, especially in the elderly or with concomitant medication use.

Genetic Factors: Patients with G6PD deficiency may have an increased risk of hemolytic anemia.

Lab Test Interference: None significant.

Overdose Management

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

Treatment: Administer oral glucose if conscious; for severe cases, may require IV glucose or glucagon; monitor closely and provide supportive care.

Storage and Handling

Storage: Store at room temperature in a tightly closed container, away from heat and moisture.

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.