Details About Generic Salt ::  Tolbutam

Main Medicine Class:: Antidiabetic,sulfonylurea   

(tole-BYOO-tuh-mide)
Orinase, Orinase Diagnostic,  Apo-Tolbutamide, Novo-Butamide
Class: Antidiabetic/sulfonylurea

 

Drugs Class ::

 Action Decreases blood glucose by stimulating release of insulin from pancreas.

Indications for Drugs ::

 Indications

Oral form: Adjunct to diet to lower blood glucose in patients with non-insulin-dependent diabetes mellitus (type II) whose hyperglycemia cannot be controlled by diet alone. IV form (tolbutamide sodium): Aid in diagnosis of pancreatic islet cell adenoma.

Drug Dose ::

 Route/Dosage

ADULTS: PO Usually 1–2 g/day (range, 0.25–3 g) in 1–2 divided doses.

For Diagnostic Purposes

ADULTS: IV 1 g over 2–3 min.

Contraindication ::

 Contraindications Hypersensitivity to sulfonylureas; diabetes complicated by ketoacidosis with or without coma; sole therapy of insulin-dependent (type I) diabetes mellitus; diabetes occurring during pregnancy.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Insulin is recommended to control elevated blood glucose levels during pregnancy. Lactation: Excreted into breast milk. Children: Safety and efficacy have not been established. Elderly or debilitated patients: Particularly susceptible to hypoglycemic action. Hypoglycemia may be difficult to recognize in elderly. Disulfiram-like syndrome: Administration of drug with alcohol may induce facial flushing and breathlessness. Hepatic and renal impairment: Use drug with caution. Cardiovascular risk: Patients treated for 5 to 8 years with diet plus tolbutamide (1.5 g/day) ad a rate of cardiovascular mortality » 2.5 times that of patients treated with diet alone.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CV: Increased risk of cardiovascular mortality. CNS: Dizziness; vertigo. DERM: Allergic skin reactions; eczema; pruritus; erythema; urticaria; orbilliform or maculopapular eruptions; lichenoid reactions; porphyria; photosensitivity. EENT: Tinnitus. GI: Nausea; epigastric fullness; heartburn. HEMA: Leukopenia; thrombocytopenia; aplastic anemia; agranulocytosis; emolytic anemia; pancytopenia. HEPA: Cholestatic jaundice. META: Hypoglycemia; SIADH with water retention and dilutional hyponatremia, especially in patients with CHF or hepatic cirrhosis. OTHER: Disulfiram-like reaction; weakness; paresthesia; fatigue; malaise; light burning sensation along course of vein during IV injection; thrombophlebitis with thrombosis of injected vein.

Drug Mode of Action ::  

 Action Decreases blood glucose by stimulating release of insulin from pancreas.

Drug Interactions ::

 Interactions

Androgens, anticoagulants, azole antifungals, chloramphenicol, clofibrate, dicumarol, fenfluramine, fluconazole, gemfibrozil, histamine H2 ntagonists, magnesium salts, methyldopa, MAO inhibitors, phenylbutazone, probenecid, salicylates, sulfinpyrazone, sulfonamides, tricyclic antidepressants, urinary acidifiers: May increase hypoglycemic effect. Beta-blockers, calcium channel blockers, cholestyramine, corticosteroids, diazoxide, estrogens, hydantoins, isoniazid, nicotinic acid, oral contraceptives, phenothiazines, rifampin, sympathomimetics, thiazide diuretics, thyroid agents, urinary alkalinizers: May decrease hypoglycemic effect. Charcoal: Charcoal can reduce the absorption of sulfonylureas; depending on the clinical situation, this will reduce their efficacy or toxicity. Digitalis glycosides: Concurrent administration may result in increased digitalis serum levels. Digoxin: May cause increased digoxin serum concentrations. Ethanol: May cause disulfiram-like reaction.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note diabetes complicated by ketoacidosis, decreased renal or hepatic function or sensitivity to sulfa drugs.
  • If renal or hepatic function is diminished, use cautiously and monitor function.
  • Monitor elderly closely for hypoglycemic effects.
  • Monitor vital signs, blood sugar, weight and I&O daily.
  • If jaundice occurs, discontinue drug and notify physician.
OVERDOSAGE: SIGNS & SYMPTOMS
  Hypoglycemia including symptoms of the following: Tingling of lips and tongue, nausea, lethargy, confusion, agitation, nervousness, tachycardia, sweating, tremor, hunger, convulsions, stupor, coma

Drug Storage/Management ::

 Administration/Storage

  • Administer 30 min prior to meal. May administer with food if GI upset occurs.
  • May administer total dose in morning or give in divided doses to decrease GI upset or to decrease blood glucose fluctuation.
  • Inject at constant rate over 2–3 min.
  • Refer to manufacturer’s product information for specific test methodology and interpretation of test results.
  • Use within 1 hr of reconstitution but only if solution is complete and clear.

Drug Notes ::

 Patient/Family Education

  • Instruct patient to follow the diet and exercise regimen prescribed by physician.
  • Inform patient of symptoms of and treatment for low blood sugar and advise patient to carry source of sugar at all times.
  • Instruct patient to avoid alcohol. Inform patient that alcohol may react with tolbutamide and cause antabuse-like reaction (flushing, headache, dizziness, high BP).
  • Instruct patient to monitor weight and to inform physician if steady weight gain occurs.
  • Inform patient that surgery, illness or trauma may require temporary use of insulin.
  • Instruct patient to alert physician to following problems: Nausea, vomiting, GI distress, diarrhea, fever, sore throat, rash, itching, weakness, unusual bruising or bleeding, spilling of glucose or ketones in urine.
  • Caution patient to avoid exposure to sunlight and to use sunscreen or wear protective clothing to avoid photosensitivity reaction.
  • Recommended that patient carry identification card (eg, Medi-Alert) indicating condition and drug therapy.

Disclaimer ::

The Information available on this site is for only Informational Purpose , before any use of this information please consult your Doctor .Price of the drugs indicated above may not match to real price due to many possible reasons may , including local taxes etc.. These are only approximate indicative prices of the drug.

DOWNLOAD OUR ANDROID APP

One of the 1st in India.High Quality Generic Medicine Portal Android Application for Online Oreder & Information.

For More Join Our Membership and Get Additional 25% off on Meds, also get MLM Benefits to get a permanent earning source.

Join Membership How to Search Medicine
Android App

We would like to keep you updated with special notifications.