Administer activated charcoal, preferably within 1 hr of ingestion
Multiple doses may be beneficial, especially for glipizide
Initial therapy regardless of known cause
50mL D50W bolus
Start a D10 1/2NS drip  (100mL/hr)
1mL/kg of D50W OR
2mL/kg D25W OR 5-10mL/kg D10W
Neonate: 5-10 mL/kg D10W
Theoretical benefit to reduce risk of recurrent hypoglycemia
Hyperpolarization of the beta cell results in inhibition of Ca influx and prevents insulin release
50-100 mcg subcutaneous in adults with repeat dosing Q6hrs
2 mcg/kg (max 150mcg) subcutaneously Q6hrs should be used in children
Continuous infusion of 50-125 mcg/hr is an alternative in adults
Administer octreotide for 24 hours, then after discontinuing, monitor for hypoglycemia for another 24 hours
Glucagon 5mg IM may be used as temporizing measure, e.g. while obtaining IV access
Dependent on glycogen stores which may be depleted in prolonged hypoglycemia
Also short duration of action
Caution in using glucagon drip
Glucagon also has an insulin-releasing effect
May subsequently cause initial paradoxical hypoglycemia
Dependent on glycogen stores which may be depleted in prolonged hypoglycemia
Also short duration of action
Caution in using glucagon drip
Glucagon also has an insulin-releasing effect
May subsequently cause initial paradoxical hypoglycemia
Glucagon also has an insulin-releasing effect
May subsequently cause initial paradoxical hypoglycemia
Sulfonylurea toxicity
Anti-hyperglycemic
Xylazine toxicity
Insulin
Monoamine oxidase inhibitor toxicity
Oral secretagogue
Acetaminophen toxicity
Antimony toxicity