Dangerous misuse of sulphonylureas.

Abstract

pneumonia after pilocarpine toxicity but declaring that there was no evidence as to where, when, or how the drug had been administered. The Department of Health and Social Security has highlighted the ease of access to most hospitals5 and in 1982 asked health authorities to review their procedures for keeping equipment, stock, and premises secure and to develop a security strategy. There are no reports of hospital security in the United Kingdom, but the topic is occasionally aired in the United States. For example, Coiling outlined incidents of rape, robbery, kidnapping, assault, and even homicide, which were occurring with increasing frequency on hospital campuses.6 He emphasised that a well organised security programme was essential for the provision of excellent patient care. As food containers travel up to a third of a mile from the kitchen area to wards in West Park Hospital it was clear that tighter security was necessary. All the food containers are now sealed either with a plastic heat sealed bond or within a polythene bag sealed with a ratchet tag. The trolleys are also sealed around the body and doors. Food stores and ward larders are locked. Unauthorised access to any kitchen area, including those in the wards themselves, is prohibited; patients are not allowed in these areas. The capital cost of providing equipment to ensure the security of food was £43 000, with an annual cost of £3 500. The practice of sometimes using one minim of eye drops to treat both eyes was curtailed, thus improving the accuracy of ward pharmacy records. As a coincidental safeguard food prepared in the hospital kitchen is sampled. These samples are frozen and retained for five days. This action was a consequence of the outbreak of food poisoning at the Stanley Royd Hospital near Wakefield.' We acknowledge the cooperation of the environmental health officers of Epsom and Ewell Borough Council. We thank Colonel G M McEwan, HM Coroner for Surrey, and Dr G H Robb, consultant physician, for permission to report on these three patients.

Insulin & C-peptide levels in sulfonylurea-induced hypoglycemia: A systematic review

“…A single C-peptide value (in the BEFORE therapy group) was reported as 12,100 ng/mL [20]. This level was 270 times higher than the next highest level, and considered erroneous by the authors.…”

Inadvertent Sulfonylurea-Induced Hypoglycemia

“…12,15 Our article emphasizes the importance of an additional recommendation, which has been mentioned recently," namely, that oral hypoglycémie agents be manufactured with a distinctive shape and color easily recognized by patients, pharmacists, and physicians. Preventive measures recommended in the past have included the avoidance of use of similar trade names for different drugs by the manufacturers14; the introduction of typed prescription forms12 using generic names14; and instruc¬ tion of patients to identify their drugs.…”

Prescribing errors in diabetes

“…15 Literature relating to errors in the use of oral sulphonylureas commonly deals with erroneous delivery of a sulphonylurea to a non-diabetic patient. 16,17 however, poor prescription writing can also have the opposite effect. For example, a patient received chlorpromazine instead of chlorpropamide.…”