Metformin Flashcards
what class of drug is metformin
Biguanide
what does metformin inhibit?
complex 1 of the mitochondrial respiratory chain
what does inhibition of complex one of the mitochondrial resp chain lead to?
Fall in cellular ATP (rise in ADP/ATP ratio)
a fall in cellular ATP in relation to metformin leads to
a reduction in gluconeogenesis
is metformin hydrophilic or hydrophobic?
hydrophilic
does metformin require active transport?
yes, by organic cation transporters (OCT)
where are organic cation transporters found?
intestines, liver and kidney
metformin is excreted unchanged in urine-true or false?
true (means its not metabolised)
what is the main impact of metformin?
lowers hepatic glucose production (in patients with poorly controlled diabetes)
increases gut glucose utilisation and metabolism
decreases lipogenesis
does metformin increase tissue sensitivity to insulin?
No
does metformin cause weight loss?
yes
what is a normal metformin dose?
500mg bd
what is the max dose of metformin?
1g bd
how many patients have a GI side affect?
20% have GI intolerance
5% have to stop because of these symptoms (Diarrhoea, Bloating, Abdominal Pain, Dyspepsia, Metallic taste in mouth)
how are metformin side effects reduced?
initiate medication slowly
does metformin increase lactate production?
yes
in what is metformin associated with a greater risk of lactic acidosis?
acute kidney injury
what are other benefits of metformin?
has a largely sustained benefit on CV mortality
