Professional and Linguistic Assessments Board (PLAB) Practice Exam

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What substance is contraindicated when prescribing sulfonylureas?

Insulin
Alcohol
Metformin
Gliptins

The correct answer is: Alcohol

When prescribing sulfonylureas, caution is advised regarding the use of alcohol because of the potential for adverse reactions. Alcohol can enhance the hypoglycemic effects of sulfonylureas, leading to an increased risk of severe low blood sugar (hypoglycemia). This is particularly concerning as the symptoms of hypoglycemia, such as dizziness and confusion, can be similar to the effects of alcohol intoxication, making it difficult for patients to recognize when they are experiencing low blood sugar levels. Moreover, the combination of alcohol and sulfonylureas can lead to a disulfiram-like reaction, especially with certain medications in this class, resulting in symptoms like flushing, nausea, and palpitations. Therefore, it is crucial for patients on sulfonylureas to avoid alcohol to maintain safe blood glucose levels and prevent these potentially harmful interactions. In contrast, insulin, metformin, and gliptins do not have the same level of concern when taken along with sulfonylureas. While using these other medications may require careful management of blood sugar levels, they do not typically produce the same contraindications associated with alcohol consumption.