Acute renal failure after massive ingestion of gliclazide in a suicide attempt

Barracca, A; Ledda, O.; Michittu, B; Pili, G.; Manca, Oscar; Pani, Antonello; Altieri, Paolo

doi:10.3109/08860229809045142

Cited by 7 publications

(4 citation statements)

References 5 publications

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“…Oral medications like glipizide and gliclazide have been used for attempted suicide in patient with DM. [3536] Metformin has been used in massive quantities with an intent to self-harm in a few patients. [4647484950] Use of excess doses of metformin results in lactic acidosis which may result in cardiac arrest[4750] and even death.…”

Section: Introductionmentioning

confidence: 99%

Diabetes mellitus and suicide

Sarkar

Balhara

2014

Indian J Endocr Metab

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Relationship of diabetes mellitus (DM) with metal health disorders such as depression has been explored extensively in the published literatures. However, association of diabetes mellitus with suicidal tendencies has been evaluated less extensively. The present narrative review aimed to assess the literature relating to diabetes mellitus and suicide. As a part of the review, Pubmed and Google Scholar databases were searched for English language peer reviewed published studies with keywords relating to diabetes and suicide. Additional references were identified using cross-references. The available literature suggests that suicidal ideas and attempts are more frequent in patients with diabetes mellitus than healthy or medically ill controls. Although, a few studies report evidence to the contrary. Suicide accounts for a large proportion of deaths in patients with diabetes mellitus type I (T1DM), and their mortality rate is higher than that of age matched control population. Psychological morbidity, including depression, precedes suicidal ideas and attempts; though many other factors can be hypothesized to impact and modulate this association. A common method of suicide attempt in patients with diabetes includes uses of high doses of insulin and its congeners or medications to treat the disease. Regular screening and prompt treatment of depression and suicidality is suggested for patients with DM.

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Section: Introductionmentioning

confidence: 99%

Diabetes mellitus and suicide

Sarkar

Balhara

2014

Indian J Endocr Metab

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“…He required dialysis and recovered his renal function 10 days postingestion 6. It was this case report and results of initial biochemical investigations that prompted us to pursue investigations to look for the presence of oral hypoglycaemia agents in our patient in spite of repeated denials by the patient and no history forthcoming of any member in the current family being on hypoglycaemic medications despite our direct questioning.…”

Section: Discussionmentioning

confidence: 90%

Dilemma of diagnosing sulphonylurea overdose in children: deliberations and considerations before reaching a diagnosis

2017

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A 15-year-old non-diabetic Caucasian girl presented with sudden onset of seizures, unrecordable blood glucose readings and acute renal failure. She denied any medication ingestion and no other precipitating factors were encountered for this acute presentation. She was treated with intravenous glucose infusion and hydrocortisone injection. Investigations showed a non-ketotic hypoglycaemia with high C-peptide and insulin levels. It took several days and multiple investigations to establish the exact cause of her persistent hypoglycaemia before it was concluded to be secondary to gliclazide overdose in a suicide attempt by the young girl. She made a complete recovery in a week with no apparent lasting neurological or renal impairment.

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“…The V ss was predicted by Simcyp Rodgers et al + ion membrane permeability model. The Kp scalar of 3.5 was used to adjust the predicted V ss value to those observed in humans in vivo (0.19–0.46 L/kg) [ 32 , 33 , 34 , 35 ]. The intrinsic clearances per pmol of CYP enzymes were calculated using total intrinsic clearance measured in vitro in human liver microsomes [ 10 ], and f m values obtained from in vivo data [ 36 ].…”

Section: Methodsmentioning

confidence: 99%

Interaction between Omeprazole and Gliclazide in Relation to CYP2C19 Phenotype

Dujić

Cvijić

Elezovic

et al. 2021

JPM

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The antidiabetic drug gliclazide is partly metabolized by CYP2C19, the main enzyme involved in omeprazole metabolism. The aim of the study was to explore the interaction between omeprazole and gliclazide in relation to CYP2C19 phenotype using physiologically based pharmacokinetic (PBPK) modeling approach. Developed PBPK models were verified using in vivo pharmacokinetic profiles obtained from a clinical trial on omeprazole-gliclazide interaction in healthy volunteers, CYP2C19 normal/rapid/ultrarapid metabolizers (NM/RM/UM). In addition, the association of omeprazole cotreatment with gliclazide-induced hypoglycemia was explored in 267 patients with type 2 diabetes (T2D) from the GoDARTS cohort, Scotland. The PBPK simulations predicted 1.4–1.6-fold higher gliclazide area under the curve (AUC) after 5-day treatment with 20 mg omeprazole in all CYP2C19 phenotype groups except in poor metabolizers. The predicted gliclazide AUC increased 2.1 and 2.5-fold in intermediate metabolizers, and 2.6- and 3.8-fold in NM/RM/UM group, after simulated 20-day dosing with 40 mg omeprazole once and twice daily, respectively. The predicted results were corroborated by findings in patients with T2D which demonstrated 3.3-fold higher odds of severe gliclazide-induced hypoglycemia in NM/RM/UM patients concomitantly treated with omeprazole. Our results indicate that omeprazole may increase exposure to gliclazide and thus increase the risk of gliclazide-associated hypoglycemia in the majority of patients.

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Acute renal failure after massive ingestion of gliclazide in a suicide attempt

Abstract: Gliclazide, a suI$onlyurea class molecule, is used to control glycaemic levels in non insulin

Cited by 7 publications

References 5 publications

Diabetes mellitus and suicide

Diabetes mellitus and suicide

Dilemma of diagnosing sulphonylurea overdose in children: deliberations and considerations before reaching a diagnosis

Interaction between Omeprazole and Gliclazide in Relation to CYP2C19 Phenotype

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