An 88-year-old man with a history of diabetes, hypertension, and stage 4 chronic kidney disease presents with profound lethargy and periods of unresponsiveness.
A blood glucose level obtained on admission to the emergency room was 40 mg/dL. Other laboratory findings included a creatinine level of 2.8 mg/dL and blood urea nitrogen of 48 mg/dL.
The patient became alert and talkative following the administration of 10% dextrose but required a continuous infusion of dextrose during the first eight hours of observation to maintain a blood glucose level in the mid-80 mg/dL range. Neither the patient nor his family can provide his current medication list.
Which of the following medications is the most likely cause of this patient’s symptoms?
This question appears in Med-Challenger Internal Medicine Exam Review with CME
Try for free and save. Ace your exams and meet your CME/MOC requirements for just $35 a month!