Hypoglycemia prevention

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. 

When discontinuing parenteral nutrition, it is important to taper over several days to prevent hypoglycemia... 

Regular insulin has a relatively slow onset of action when given subcutaneously, requiring injection 30 minutes prior to meals to achieve optimal postprandial glucose control and to prevent delayed postmeal hypoglycemia. 

Diabetes mellitus and hypoglycemia -blockade may prevent the appearance of premonitory signs and symptoms of acute hypoglycemia. -blockade also reduces insulin release it may be necessary to adjust antidiabetic drug dose. 

Coriander Coriandrum sativum) Uses t Appetite, treat D, dyspep-sia, flatulence Action Stimulates gastric secretions, spasmolytic effects Available forms Tine 10-30 gtts PO OD Contra w/ PRG or lactation Notes/SE N/V, fatty liver tumors, allergic skin Rxns Interactions T Effects OF oral hypoglycemics EMS T Risk of photosensitivity Rxns may cause hypoglycemia Cranberry [Vaeeinium macreearpon) Uses Prevention UTI urinary deodorizer in urinary incontinence Actions Interferes w/ bacterial adherence to epithelial cells of the bladder Available forms Caps 300-500 mg PO bid-qid unsweetened juice 8-16 oz daily tine 3-5 mL or tincture 1/2-1 tsp up to 3X/d, tea 2-3 tsps of dried flowers/cup creams apply topically 2-3X/d PO SE D, irritation, nephrolithiasis if T urinary Ca oxalate Interactions T Effects OF warfarin ... 

Geriatric Considerations-Summary G1 effects maybe even more prevalent in older adults. Not associated with hypoglycemia when used as monotherapy. If hypoglycemia occurs in a patient taking acarbose, use oral glucose for treatment as acorbose may prevent the absorption of other complex carbohydrates. Avoid In older adults with SCr> 2 mg/dl. 

Chelliah A, Burge MR. Hypoglycemia in elderly patients with diabetes mellitus. Causes and strategies for prevention. Drugs Aging 2004 2 i 5 i i-530. 

Pramlintide is approved for concurrent mealtime administration in individuals with type 2 diabetes treated with insulin, metformin, or a sulfonylurea who are unable to achieve their postprandial glucose targets. Combination therapy results in a significant reduction in early postprandial glucose excursions mealtime insulin or sulfonylurea doses usually have to be reduced to prevent hypoglycemia. 

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