Biguanides Flashcards
1
Q
Biguanide example
A
Metformin
2
Q
Biguanide effect on hepatocytes
A
dec gluconeogenesis –> dec hep glucose produx
dec cholesterol, TG, and FA synth
3
Q
Biguanide effect on SKM
A
Inc GLUT4 translocation –> inc glucose uptake
4
Q
Biguanide AE
A
1. Gastrointestinal - very common NVD anorexia abd discomfort metallic taste dec vit B12 absorp
- Lactic acidosis - very rare!
5
Q
Biguanide Considerations
A
1st line choice
Slowly titrate on w food
6
Q
Biguanide CI
A
-severe renal impairment (eGFR < 30 ml/min)
liver disease
ETOH abuse
HF
-hemodynamic instability due to infection or other
causes
7
Q
What parameters should be monitored with Biguanides?
A
GFR
HbA1c
BG
8
Q
Biguanide side note - other uses?
A
dec ovarian androgen produx –> adj therapy for PCOS
9
Q
Temporarily discontinue biguanide in pts with:
A
acute dehydration
sepsis
IV iodinated contrast material
