Sick days and missed tablets

If the patient misses a tablet he should not take double next time! Discuss each case individually. If the error is realized within two hours of the correct time take the missed dose immediately. In someone on once daily breakfast-time therapy, the missed dose could be taken within four hours of the correct time. If the patient has a vomiting illness or severe diarrhoea not only will he be unable to keep his tablets down (or fail to absorb them) but the illness is likely to push his blood glucose concentration up. The patient must contact his doctor immediately. Monitor the blood glucose carefully and use insulin to control it. Keep a particularly careful eye on elderly patients' blood glucose levels—vague confusion may indicate hypoglycaemia. Non-specific symptoms can be accompanied by gross metabolic derangement and high glucose levels.

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