RN Nursing · Diabetes Mellitus — Type 2 · Practice question
A nurse is reviewing the medication list of a patient prescribed glyburide for type 2 diabetes mellitus and notes a documented allergy to sulfonamides. What is the nurse's best initial action based on recognizing this cue?
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Hold the glyburide and notify the provider about the sulfonamide allergy.
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Administer glyburide as prescribed since the allergy does not cross-react with oral antidiabetics.
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Assess the patient for symptoms of hypoglycemia before administering glyburide.
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Administer an antihistamine before giving glyburide to prevent allergic reactions.
Answer & explanation
Correct: Hold the glyburide and notify the provider about the sulfonamide allergy.
Glyburide is a sulfonylurea, a class of oral antidiabetic medications that contains a sulfonamide chemical structure. Clients with documented allergies to sulfonamides may exhibit cross-reactivity with sulfonylureas such as glyburide, putting them at risk for a potentially serious allergic reaction. Therefore, the nurse's best initial action is to hold the medication and notify the provider so the allergy can be evaluated and an alternative antidiabetic agent prescribed if necessary. Administering glyburide as prescribed without addressing the allergy is unsafe because cross-reactivity, though debated in the literature, remains a documented clinical concern that warrants provider review before administration. Assessing for hypoglycemia is relevant to sulfonylurea therapy in general but does not address the immediate safety concern posed by the documented allergy. Administering an antihistamine prophylactically before giving a potentially allergenic drug is not an accepted practice and does not eliminate the risk of a serious reaction. The correct nursing response when a potential allergy-drug interaction is identified is always to withhold the drug and communicate the concern to the prescriber before administration.
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