Hypoglycemia and

For many years, there has been concern by medical professionals and nutritionists over the effects of dietary sugar on human health. Sucrose has been imphcated as a cause of juvenile hyperactivity, tooth decay, diabetes meUitus, obesity, atherosclerosis, hypoglycemia, and nutrient deficiencies. 

Toxic effects of propranolol are related to its blocking P-adrenoceptor blocking actions. They include cardiac failure, hypotension, hypoglycemia, and bronchospasm. Propranolol is lipophilic and crosses the blood—brain barrier. Complaints of fatigue, lethargy, mental depression, nightmares, hallucinations, and insomnia have been reported. GI side effects include nausea, vomiting, diarrhea, and constipation (1,2). 

Many derivatives of 4-hydroxy-3-nitro-l,X-naphthyridin-2(lH)-ones (X = 5,6,7, and 8) were claimed to have been used for treating or preventing neuronal loss associated with stroke, ischemia, CNS trauma, hypoglycemia, and surgery as well as for treating neurodegenerative diseases, chronic pain, convulsion, anxiety, and opiate tolerance (96MI2). 

Insulin and the oral antidiabetic dmgi, alongwith diet and exercise are die cornerstones of treatment for diabetes mellitus. They are used to prevent episodes of hypoglycemia and to normalize carbohydrate metabolism. 

Know the symptoms of hypoglycemia and hyperglycemia and the health care provider s method for terminating a hypoglycemic reaction. 

Glucagon is secreted as a response to hypoglycemia and activates both glycogenolysis and gluconeogenesis in the liver, causing release of glucose into the blood. 

Monitor for adverse effects of 3-blockers—heart rate, blood pressure, fatigue, masking of symptoms of hypoglycemia and/or glucose intolerance (in patients with diabetes), wheezing or shortness of breath (in patients with asthma or chronic obstructive pulmonary disease), etc. 

Protonated THAM (with CP or HCO, ) is excreted in the urine at a rate that is slightly higher than creatinine clearance. As such, THAM augments the buffering capacity of the blood without generating excess C02. THAM is less effective in patients with renal failure and toxicities may include hyperkalemia, hypoglycemia, and possible respiratory depression. 

Isolated seizures that are not epilepsy can be caused by stroke, central nervous system trauma, central nervous system infections, metabolic disturbances (e.g., hyponatremia and hypoglycemia), and hypoxia. If these underlying causes of seizures are not corrected, they may lead to the development of recurrent seizures I or epilepsy. Medications can also cause seizures. Some drugs that are commonly associated with seizures include tramadol, bupropion, theophylline, some antidepressants, some antipsy-chotics, amphetamines, cocaine, imipenem, lithium, excessive doses of penicillins or cephalosporins, and sympathomimetics or stimulants. 

Hypoglycemia and weight gain are at a reduced risk due to short duration of action ... 

During an acute adrenal crisis, the immediate treatment goals are to correct volume depletion, manage hypoglycemia, and provide glucocorticoid replacement. 

Because GH deficiency may be accompanied by the loss of other pituitary hormones, hypoglycemia and hypothyroidism also may be noted. 

Some of the participants reported health benefits such as relief from sinus congestion, reduction in the desire to smoke and drink alcohol as well as lowered blood pressure. Of the 112 participants, a total of 580 kilograms or 1,276.8 pounds were lost during the seven-day period, an average of 1.6 pounds per person daily. Two people discontinued the program complaining of side effects of hypoglycemia and another person... 

The answer is d, (Hardman, pp 855-856.) Propranolol, as well as other non selective beta blockers, tends to slow the rate of recovery in a hypoglycemic attack caused by insulin. Beta blockers also mask the symptoms of hypoglycemia and may actually cause hypertension because of the increased plasma epinephrine in the presence of a vascular beta2 blockade. 

Gibson, G. E. and Blass, J. P. Impaired synthesis of acetylcholine in brain accompanying hypoglycemia and mild hypoxia. /. Neurochem. 27 37-42,1976. 

Older child (2-5 years) recurrent vomiting, metabolic acidosis, hypoglycemia and progressive lethargy Speech delay developmental delay usually is mild... 

Neutral protamine hagedorn (NPH) is intermediate-acting. Variability in absorption, inconsistent preparation by the patient, and inherent pharmacokinetic differences may contribute to a labile glucose response, nocturnal hypoglycemia, and fasting hyperglycemia. 

Hypoglycemia and weight gain are the most common adverse effects of insulin. Treatment of hypoglycemia is as follows ... 

Patients receiving insulin should be questioned about the recognition of hypoglycemia at least annually. Documentation of frequency of hypoglycemia and the treatment required should be recorded. 

---