Home Drug Guide Acetohexamide

Drug Guide

Generic Name

Acetohexamide

Brand Names Dymelor

Classification

Therapeutic: Antidiabetic agent

Pharmacological: Sulfonylurea

FDA Approved Indications

Management of type 2 diabetes mellitus as an adjunct to diet and exercise

Mechanism of Action

Stimulates insulin release from pancreatic beta cells by inhibiting ATP-sensitive potassium channels, leading to insulin secretion and decreased blood glucose levels.

Dosage and Administration

Adult: Initial dose: 250 mg once daily, titrate based on blood glucose response. Typical maintenance dose: 250-500 mg daily in divided doses.

Pediatric: Not typically used in pediatric patients.

Geriatric: Start at lower doses due to potential sensitivity and comorbidities; monitor glycemic response closely.

Renal Impairment: Use with caution; dose adjustments may be necessary. Frequent monitoring is advised.

Hepatic Impairment: Use with caution; dose adjustments may be necessary; monitor hepatic function.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed in body tissues.

Metabolism: Metabolized in the liver.

Excretion: Excreted primarily via the kidneys.

Half Life: Approximately 4 hours.

Contraindications

Type 1 diabetes mellitus
Diabetic ketoacidosis
Hypersensitivity to sulfonylureas

Precautions

History of hypersensitivity reactions, liver disease, renal impairment, or pregnancy. Women who are pregnant or breastfeeding should consult healthcare providers before use.

Adverse Reactions - Common

Hypoglycemia (Common)
Gastrointestinal disturbances (nausea, vomiting, epigastric discomfort) (Common)

Adverse Reactions - Serious

Allergic skin reactions (rash, urticaria) (Rare)
Blood dyscrasias (aplastic anemia, leukopenia) (Rare)

Drug-Drug Interactions

Other antidiabetic agents (risk of hypoglycemia), NSAIDs (may enhance hypoglycemic effect), alcohol (may potentiate hypoglycemia)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose levels regularly, assess for signs of hypoglycemia, liver function, and renal function.

Diagnoses:

Risk for hypoglycemia
Ineffective tissue perfusion related to hypoglycemia

Implementation: Administer with meals to reduce gastrointestinal upset; educate patient on recognizing hypoglycemia.

Evaluation: Evaluate glycemic control and monitor side effects.

Patient/Family Teaching

Take medication exactly as prescribed.
Monitor blood glucose regularly.
Recognize symptoms of hypoglycemia and how to treat it (e.g., glucose tablets).
Report signs of allergic reactions or unusual symptoms to healthcare provider.

Special Considerations

Black Box Warnings:

Risk of hypoglycemia, especially in improper dosing or with other hypoglycemic agents.

Genetic Factors: No specific genetic considerations known.

Lab Test Interference: May interfere with certain blood glucose test readings.

Overdose Management

Signs/Symptoms: Severe hypoglycemia including sweating, weakness, confusion, seizures, coma.

Treatment: Administer glucose orally if conscious; if unconscious, administer dextrose intravenously; monitor blood glucose levels closely.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F). Keep container tightly closed.

Stability: Stable under recommended storage conditions.