diazoxide (redirected from Proglycem)

diazoxide /di·az·ox·ide/ (di″az-ok´sīd) an antihypertensive structurally related to chlorothiazide but having no diuretic properties; used for treatment of hypertensive emergencies. Because it inhibits release of insulin, it is also used in hypoglycemia due to hyperinsulinism.

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diazoxide

[dī′əzok′sīd]

a vasodilator used as an antihypertensive. It also inhibits insulin release from the pancreas.

indications It is prescribed parenterally for emergency reduction of blood pressure in malignant hypertension and orally in some cases of hypoglycemia.

contraindications Compensatory hypertension (e.g., coarctation of the aorta), cerebral bleeding, or known hypersensitivity to this drug or other thiazides prohibits its use. Caution is advised in heart disease, pregnancy, and impaired kidney function.

adverse effects Among the more serious adverse reactions are tachycardia, sodium and water retention, hyperglycemia, and severe hypotension.

note This drug is for IV use in hospitalized patients only. Severe hypotension may result from its use.

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diazoxide

an oral agent that inhibits insulin release, enhances glycogenolysis and inhibits the uptake of glucose; used to treat hypoglycemia due to hyperinsulinism.

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diazoxide

Eudemine (UK), Hyperstat IV, Proglycem (CA)

Pharmacologic class: Vasodilator

Therapeutic class: Antihypertensive (nondiuretic), antihypoglycemic

Pregnancy risk category C

Action

Unclear. Relaxes peripheral arterioles of smooth-muscle cells and reduces peripheral vascular resistance as a result of vasodilation.

Availability

Capsules: 50 mg

Injection: 15 mg/ml in 20-ml ampules

Oral suspension: 50 mg/ml

⊘Indications and dosages

➣ Hypertensive crisis

Adults and children: 1 to 3 mg/kg I.V. bolus, to a maximum dosage of 150 mg q 5 to 15 minutes until adequate response occurs. Repeat as needed q 4 hours or more.

➣ Hypoglycemia secondary to hyperinsulinism

Adults and children: 3 to 8 mg/kg P.O. daily in two to three divided doses q 8 to 12 hours

Newborn and infants: 3.3 mg/kg P.O. q 8 hours

Off-label uses

• Pregnancy-induced hypertension
• Obesity

Contraindications

• Hypersensitivity to drug, thiazides, or sulfonamides
• Compensatory hypertension
• Pheochromocytoma
• Dissecting aortic aneurysm

Precautions

Use cautiously in:
• fluid and electrolyte imbalances; impaired renal, hepatic, cerebral, or cardiac circulation
• pregnant or breastfeeding patients
• children.

Administration

• Keep patient recumbent during I.V. administration and for at least 30 minutes afterward.
• Give single I.V. doses over 10 to 30 seconds. Continuous I.V. infusion can be given at a constant rate (7.5 to 30 mg/minute) until adequate response occurs.

Route	Onset	Peak	Duration
P.O.	1 hr	Unknown	8 hr
I.V.	1 min	2-5 min	2-12 hr

Adverse reactions

CNS: headache, light-headedness, dizziness, weakness, euphoria, seizures , paralysis , cerebral ischemia

CV: ECG changes, orthostatic hypotension, angina pectoris, myocardial ischemia, myocardial infarction, arrhythmias, shock, supraventricular tachycardia, heart failure

EENT: optic nerve damage

GI: nausea, vomiting, diarrhea, constipation, abdominal discomfort, dry mouth

GU: breast tenderness

Metabolic: hyperglycemia, hyperuricemia, fluid and electrolyte imbalances, sodium and water retention

Skin: inflammation (with extravasation), diaphoresis, flushing

Other: sensation of warmth, edema, pain (with extravasation)

Interactions

Drug-drug. Antihypertensives (such as beta-adrenergic blockers, hydralazine, methyldopa, minoxidil, nitrates, prazosin, reserpine): additive hypotension

Hydantoins: decreased hydantoin blood level

Sulfonylureas: hyperglycemia

Thiazide diuretics: increased diazoxide effects

Drug-diagnostic tests. Blood urea nitrogen, glucose, serum sodium, uric acid: increased levels

Eosinophils, hematocrit, hemoglobin, platelets, white blood cells: decreased values

Patient monitoring

☞ Measure blood pressure every 5 minutes for first 15 to 30 minutes of infusion or until patient stabilizes.
• Monitor ECG and pulse continuously during and after infusion. Be aware that tachycardia may immediately follow I.V. infusion.
• Assess fluid status; promptly report intake and output changes. If fluid retention occurs, give diuretic, as prescribed.
• Inspect I.V. site regularly for infiltration or extravasation.
• Observe closely for signs and symptoms of heart failure.
• Monitor diabetic patient for loss of glycemic control.

Patient teaching

☞ Instruct patient to immediately report chest pain, dizziness, and severe headache.
• Tell patient to weigh himself daily and report significant gains.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.