Pharmacology

1. 
   

   Diazoxide, a nondiuretic thiazide, is a direct arterial vasodilator that formerly was used to treat severe hypertension. Heart rate and cardiac output increase owing to a reflex response to decreased peripheral vascular resistance. The duration of the hypotensive effect ranges from 3 to 12 hours, although the elimination half-life is 20–40 hours.

   
   
2. 
   

   Diazoxide has been used in the treatment of oral hypoglycemic overdose because it increases serum glucose by inhibiting insulin secretion, diminishing peripheral glucose utilization, and enhancing hepatic glucose release. However, octreotide (See Octreotide) has become the preferred agent because of its safety and efficacy.

Indications

1. 
   

   Management of an acute hypertensive crisis, although other antihypertensive agents are preferred (see “Phentolamine,” “Nitroprusside,” and “Labetalol,”).

   
   
2. 
   

   Oral hypoglycemic overdose when serum glucose concentrations cannot be maintained adequately by intravenous 5% dextrose infusions and the preferred agent, octreotide, is unavailable or the patient cannot tolerate it (known hypersensitivity).

Contraindications

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