Nurses Compass
Drug Guide
Diazoxide
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.