A 67-year-old man with type 2 diabetes mellitus on metformin presents with acute onset facial flushing, nausea, and palpitations 15 minutes after consuming wine at dinner. Vital signs show BP 138/82 mmHg, HR 105/min, RR 16/min, temperature 37.2°C. Recent labs reveal fasting glucose 128 mg/dL. He recently initiated an older sulfonylurea agent that stimulates pancreatic beta cell insulin secretion. No chest pain or dyspnea noted. Which drug most likely caused his symptoms?

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

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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