SBA — Single Best Answer · Review
Question 454
Pharmacology → General
Classification
Question
SSBAQuestion Header
A patient treated with an older sulphonylurea develops mild inappropriate antidiuretic hormone activity. Which drug is specifically associated with stimulation of ADH?
Question Stem
Select the single best answer.
Options
A
Metformin
B
Glibenclamide
C
Tolbutamide
D
Gliclazide
E
Chlorpropamide
Explanation
Chlorpropamide is a sulphonylurea that inhibits liver enzymes and stimulates antidiuretic hormone. It may therefore rarely cause a mild syndrome of inappropriate antidiuretic hormone activity.
Option Validity
A) Metformin is a biguanide whose principal action is improvement of insulin sensitivity.
B) Glibenclamide stimulates insulin secretion, whereas the specific ADH effect is associated with chlorpropamide.
C) Tolbutamide has a relatively low risk of hypoglycaemia because of its low potency and short duration; stimulation of ADH is associated with chlorpropamide.
D) Gliclazide is associated with hypoglycaemia but is not the sulphonylurea associated with stimulation of ADH.
Further Reading
Saxena R. Textbook for MRCOG-1. Chapter 12: Pharmacology. Drugs Interfering with Glucose Metabolism, p.347.