Home Drug Guide Diazoxide

Drug Guide

Generic Name

Diazoxide

Brand Names Hyperstat, Proglycem

Classification

Therapeutic: Antihypertensive, Hyperglycemic agent

Pharmacological: Vasodilator, Potassium channel opener

FDA Approved Indications

  • Management of severe hypoglycemia due to hyperinsulinism
  • Control of blood pressure in hypertensive crises (Hyperstat)

Mechanism of Action

Diazoxide opens ATP-sensitive potassium channels in pancreatic beta cells, inhibiting insulin release, and causes vasodilation by relaxing vascular smooth muscle, leading to decreased blood pressure.

Dosage and Administration

Adult: For hypoglycemia: 3-8 mg/kg/day divided into doses. For hypertensive crisis: 3-15 mg/kg IV as a single dose or infusion.

Pediatric: Dose varies; typically 1-5 mg/kg every 8-12 hours for hypoglycemia.

Geriatric: Adjust dose based on renal function and tolerability.

Renal Impairment: Reduce dose as renal clearance may be decreased.

Hepatic Impairment: Use caution; dose adjustment may be necessary.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses the placenta.

Metabolism: Minimal hepatic metabolism.

Excretion: Primarily renal, highly bound to plasma proteins.

Half Life: 2-8 hours.

Contraindications

  • Hypersensitivity to diazoxide.
  • Previous adverse reactions such as hypotension, tachycardia, or fluid retention.

Precautions

  • Use with caution in patients with heart failure, renal impairment, or edema. Monitor blood pressure, blood glucose, and electrolytes regularly. Avoid in pregnancy unless clearly needed; use contraception.

Adverse Reactions - Common

  • Fluid retention and edema (Common)
  • Hypotension (Common)
  • Hyperglycemia (Common)
  • Nausea, vomiting (Common)

Adverse Reactions - Serious

  • Heart failure (Serious)
  • Hypertrichosis (Serious)
  • Thrombocytopenia, leukopenia (Serious)
  • Pulmonary hypertension (Serious)

Drug-Drug Interactions

  • Corticosteroids may enhance fluid retention.
  • Other antihypertensives may increase hypotensive effects.

Drug-Food Interactions

  • None specific

Drug-Herb Interactions

  • None well-documented

Nursing Implications

Assessment: Monitor blood pressure, blood glucose, electrolytes, and signs of fluid retention.

Diagnoses:

  • Risk for hypoglycemia or hyperglycemia
  • Risk for fluid volume excess or deficit

Implementation: Administer with food to minimize GI upset. Monitor ECG if used over a long period.

Evaluation: Assess efficacy in controlling hypoglycemia or hypertension and monitor for adverse effects.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report signs of fluid overload, hypotension, or hypoglycemia.
  • Maintain routine blood tests as advised.

Special Considerations

Black Box Warnings:

  • Potential for fluid retention leading to heart failure and hyperglycemia.

Genetic Factors: No specific genetic markers currently guide use.

Lab Test Interference: May interfere with glucose monitoring and other lab tests.

Overdose Management

Signs/Symptoms: Severe hypotension, tachycardia, hyperglycemia, pulmonary edema.

Treatment: Discontinue drug immediately; provide supportive therapy, monitor cardiac and respiratory status, administer fluids or vasopressors as needed.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable for at least 2 years when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.