Endocrine drugs: sulfonylurea hypoglycaemia: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Endocrine drugs: sulfonylurea hypoglycaemia

Sample item

An elderly woman with renal impairment on glibenclamide has recurrent hypoglycaemia that returns after dextrose correction. Which drug reduces insulin release and helps in this setting?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Octreotide

Sulfonylureas close beta-cell potassium channels and cause prolonged insulin release, especially in renal failure where active metabolites accumulate. Octreotide suppresses insulin secretion and prevents recurrent hypoglycaemia. Glucagon stimulates insulin release in this setting and is less effective.

Option by option

  • A. Octreotide (correct)

    Correct. It suppresses insulin secretion from beta cells.

  • B. Insulin

    Insulin would worsen hypoglycaemia.

  • C. Glucagon infusion

    Glucagon can further stimulate insulin release in sulfonylurea poisoning and is of limited use.

  • D. Metformin

    Metformin lowers glucose and does not treat the problem.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is A, Octreotide. Sulfonylureas close beta-cell potassium channels and cause prolonged insulin release, especially in renal failure where active metabolites accumulate.

Why is "Insulin" not the answer?

Insulin would worsen hypoglycaemia.

Why is "Glucagon infusion" not the answer?

Glucagon can further stimulate insulin release in sulfonylurea poisoning and is of limited use.

Why is "Metformin" not the answer?

Metformin lowers glucose and does not treat the problem.

What concept does this question test?

It tests Endocrine drugs: sulfonylurea hypoglycaemia in Pharmacology. Octreotide suppresses insulin secretion and prevents recurrent hypoglycaemia. Glucagon stimulates insulin release in this setting and is less effective.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Endocrine drugs: sulfonylurea hypoglycaemia?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.