Biguanides

Question 1

What is the name of the only biguanide available?

Answer 1

Metformin

Question 2

What is the mechanism of action of metformin?

Answer 2

• Increases insulin sensitivity
• decreases glucose production by liver
• decreases intenstinal absorption of glucose

Question 3

True or false

metformin helps to stimulate release of insulin from beta cells in the pancreas

Answer 3

False

Question 4

Because of its action in the liver, metformin may also have what effect on lipids?

Answer 4

Decreases lipids

Question 5

True or flase

metformin is extensively metabolized by the liver

Answer 5

false

it is minimally metabolized

Question 6

True or false

Metformin is indicated as first line monotherapy in T2DM

Answer 6

True

Question 7

Metformin is associated with weight _______

Answer 7

loss

Question 8

What are the most common adverse effects of metformin?

Answer 8

GI upset (bloating, nausea, diarrhea, etc.)

Question 9

Because of its elimination pathway, metformin should be dose adjusted or avoided in patients with ________

Answer 9

Renal failure

exreted 90% unchanged by the kidneys

Question 10

Metformin has a black box warning related to _______

Answer 10

lactic acidosis

Question 11

Two major contraindications to metformin use are:

Answer 11

advanced renal disease
acute or chronic metabolic acidosis

Question 12

If a patient is undergoing radiological studies with iodine based contrast, metformin should be:

Answer 12

withheld for 48 hours prior to and following studies