Implementation

• High Alert: Accidental administration of oral hypoglycemic agents to non-diabetic adults and children has resulted in serious harm or death. Before administering, confirm that patient is diabetic. Do not confuse chlorpropamide with chlorpromazine

• Patients stabilized on a diabetic regimen who are exposed to stress, fever, trauma, infection, or surgery may require administration of insulin

» Patients previously maintained on an insulin dosages of less than 40 units/day may be started on chlorpropamide. Insulin should be immediately discontinued. Patients taking greater than 40 units/day of insulin should have their insulin doses reduced by 50% daily for the first few days, then gradually reduced further, as necessary. Monitor serum glucose and urine ketones at least 3 times/day during conversion

• PO: May be administered once in the morning or divided into 2 doses (especially if patient experiences GI distress). Administer with meals to ensure best diabetic control and minimize gastric irritation. Do not administer after last meal of the day

» Tablets may be crushed and taken with fluids if patient has difficulty swallowing

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