Glibenclamide is preferred over chlorpropamide in the treatment of diabetes mellitus because the latter is more likely to cause:
**Core Concept**
Glibenclamide and chlorpropamide are both sulfonylureas used in the treatment of type 2 diabetes mellitus. Sulfonylureas stimulate insulin release from the pancreatic beta cells by closing the ATP-sensitive potassium channels.
**Why the Correct Answer is Right**
Glibenclamide is preferred over chlorpropamide due to its shorter duration of action and fewer side effects. Chlorpropamide has a long duration of action, which can lead to an increased risk of **hypoglycemia**. Chlorpropamide also has a higher incidence of **hyponatremia** due to its antidiuretic effect, which is not seen with glibenclamide. This is because chlorpropamide can stimulate the release of antidiuretic hormone (ADH), leading to water retention and hyponatremia.
**Why Each Wrong Option is Incorrect**
**Option A:** Glibenclamide is not more likely to cause **lactic acidosis** than chlorpropamide. Both drugs can cause lactic acidosis, but this is a rare side effect and not a primary reason for preferring one over the other.
**Option B:** Chlorpropamide is not more likely to cause **thrombocytopenia** than glibenclamide. While sulfonylureas can cause thrombocytopenia, this is not a specific side effect of chlorpropamide.
**Option C:** Chlorpropamide is not more likely to cause **gastrointestinal disturbances** than glibenclamide. Both drugs can cause gastrointestinal side effects, but this is not a primary reason for preferring glibenclamide.
**Clinical Pearl / High-Yield Fact**
When choosing between glibenclamide and chlorpropamide, it's essential to consider the patient's renal function, as chlorpropamide is excreted by the kidneys and can accumulate in patients with renal impairment, leading to increased risk of side effects.
**Correct Answer: D. hyponatremia**