Please help -- question about vioxx

[susanmary]

My mother (COMPLIANT IDDM x 32 years) fell over the weekend and sprained her ankle. MD put her on Vioxx qd. Since then, she has had hypoglycemic incidents (63, 49) even with eating decent meals/snacks, no increased exercise, and not changing her insulin. She takes Humalog 70/30 tid, HCTZ, K-Dur. Can you think of why she's having these low (symptomatic) bs? She faithfully checks her blood sugars. I'm stumped. I told her to check her blood sugar this evening and to call her endocrinologist if it's low -- she does not cover bedtime blood sugars. Any thoughts? Thanks -- sometimes it's difficult to see "easy" answers when they are right in front of you when family is involved.

[sharann, BSN, RN]

Hmmmm, my drug reference only states that theres a drug interaction with thiazyde diuretics "decreases natriuretic effect of thiazides", whatever that means.

Vioxx CAN increase BP though. I wonder if her insulin vials might have been contaminated or she may have been given a different strnghth insulin (fast acting, or lantus...) Just a guess. I'm sure you already checked that out susanmary.

Hope mom is o.k soon.

[jstinerich]

I know that Vioxx and Celebrex are both chemically similar to sulfa drugs. Aren't the old type two diabetic drugs similar chemically?

[lgcv]

Cox 2 is still poorly understood, it appears to play a role in the development of the kidney, in salt and water regulation by the kidney, and in ovulation and parturition, and perhaps in an unknown brain function(s). There have been a few postmarketing reports of hypoglycemia, but not enough to be sure that the cox 2 inhibitor is to blame.

[susanmary]

Thanks for the input. I'm going to have her open a new vial of her insulin.

[NRSKarenRN, BSN, RN]

Other thoughts:

Increased stress to body can decrease insulin stores....

Also, with ankle problems, she may not be in kitchen as much as before or having same type bedtime snack. Increased protein stores needed for wound healing, make sure she has 1/2 sand or milk at bedtime to prevent AM hypoglycemia.

[susanmary]

Nurse Karen -- I know she's eating well. I cooked alot of her favorites and brought them over along with bags of groceries -- pre-mixed salads, fruit, veggies. Believe me -- she's a little Italian who eats eats eats. I'm going over to see her today to check out the situation.

[Huganurse]

NRS Karen is right.

[patadney]

Diabetics need to be very careful with the Cox 2 drugs-I did dialysis treatments on 2 pt within a couple of weeks who got dehydrated with the Viox and it caused acute renal failure, the good news is that they only needed a couple of treatments.