A 67-year-old man with type 2 diabetes mellitus presents with facial flushing, nausea, and palpitations 15 minutes after consuming wine at dinner. Vital signs show BP 145/92 mmHg, HR 108 bpm, RR 18, temp 37.2°C. He recently initiated an older sulfonylurea agent that stimulates pancreatic beta-cell insulin secretion. Fasting glucose was 118 mg/dL this morning. He denies recent hypoglycemic episodes. Which medication most likely caused this reaction?

  1. A)Acarbose
  2. B)Glyburide
  3. C)ChlorpropamideGABARITO
  4. D)Repaglinide
  5. E)Metformin

Explicação

Chlorpropamide is a first generation sulfonylurea that can produce a disulfiram like reaction after alcohol intake. Like other sulfonylureas, it increases insulin release, but this older toxicity profile is a classic clue to chlorpropamide. Ver explicação completa e trilha adaptativa →

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