When caring for a female client with a history of hypoglycemia, nurse Ruby should avoid administering a drug that may potentiate hypoglycemia. Which drug fits this description?
A. sulfisoxazole (Gantrisin)
B. mexiletine (Mexitil)
C. prednisone (Orasone)
D. lithium carbonate (Lithobid)
Correct Answer: A. sulfisoxazole (Gantrisin)
Sulfisoxazole and other sulfonamides are chemically related to oral antidiabetic agents and may precipitate hypoglycemia. The cause of the interaction is not known. When these two medicines are taken together, the body may not process the diabetes medicine properly. An increase in the effects of diabetes medicine may occur and may cause low blood sugar levels.
Option B: Mexiletine, an antiarrhythmic, is used to treat refractory ventricular arrhythmias; it doesn’t cause hypoglycemia. Mexiletine is largely used to suppress ventricular arrhythmias but also has a role in peripheral neuropathy and chronic pain, although the use for either is limited and seldom given its extensive side effect profile.
Option C: Prednisone, a corticosteroid, is associated with hyperglycemia. Prednisone is a synthetic, anti-inflammatory glucocorticoid that derives from cortisone. It is biologically inert and converted to prednisolone in the liver. Prednisone is an FDA-approved, delayed-release corticosteroid indicated as an anti-inflammatory or immunosuppressive agent to treat a broad range of diseases.
Option D: Lithium may cause transient hyperglycemia, not hypoglycemia. Lithium was the first mood stabilizer and is still the first-line treatment option, but is underutilized because it is an older drug. Lithium is a commonly prescribed drug for a manic episode in bipolar disorder as well as maintenance therapy of bipolar disorder in a patient with a history of a manic episode. The primary target symptoms of lithium are mania and unstable mood.
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