Patient took sulfonylurea..Now in OR

it is well known that Sulfonylureas are associated with hypoglycemia, which may be delayed and prolonged .
Sulfonylurea should be stopped before OR, since taking such drugs will carry the risk of intraoperative hypoglycemia specially after long hours of fasting...

So what if the patient took Sulfonylurea by mistake or patient took the drug and now admitted to OR?

Definitely glucose monitoring is crucial step...but what else..

Treatment with dextrose results in hyperglycemia(this is good)..but...
Hyperglycemia potentiates insulin release from the pancreas, resulting in recurrent hypoglycemia..

Octeotide..could it be the solution?

Octreotide mimics somatostatin, which suppresses the secretion of glucagon and insulin, among others.

Octreotide binds with somatostatin receptors, closing calcium channels, preventing the influx of calcium and subsequent insulin release.

The dose is 100 mcg SUBCUTANEOUSLY....

if you need to redose ..do it after 8 hours

Dougherty PP, Klein-Schwartz W. J. Med Toxicol 2010;6:199-206.

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