Metformin Flashcards

1
Q

What is the mechanism of action of metformin?

A

Lowers blood glucose by increasing the sensitivity to insulin, whilst suppressing hepatic glucose production, increasing glucose uptake and increasing muscular utilisation of glucose. I also suppresses intestinal glucose absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why does metformin not cause hypoglycaemia?

A

It doesn’t stimulate insulin release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Does metformin promote weight loss?

A

Yes - can prevent worsening insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are side effects of metformin?

A
  • GI upset - nausea, vomiting, taste deisturbance, anorexia, diarrhoea
  • Lactic acidosis
  • Weight loss
    *
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are indications for metformin use?

A
  • T2DM
  • PCOS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are contraindications to metformin use?

A
  • GA
  • IV contrast x-rays
  • Acute metabolic acidosis
  • eGFR < 30
  • Low BMI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When should metformin be stopped for surgery?

A

On the day of the surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When should you be cautious prescribing metformin?

A

Renal impairment - eGFR < 45 ml/min/1.73m2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How can alcohol interact with metformin?

A

CAn cause lactic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When should metformin be witheld?

A
  • AKI
  • Severe tissue hypoxia
  • Sepsis
  • Acute alcohol intoxication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

IF someone taking metformin had to go for an IV contrast media scan, how woulf this affect his prescription of metformin?

A

Withold before and 48 hours after injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What drugs can interact with metformin?

A

Those which affect renal function

  • NSAIDs
  • ACEi
  • Diuretics

Those which increase blood glucose

  • Steroids
  • Loop/thiazide fdiuretics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What dose of meformin would you start someone on?

A

500mg once per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When would you advise individuals to to take metformin?

A

With or after meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What monitoring would you consider doing with someone on metformin?

A
  • HbA1c
  • Renal function before and annually after starting treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is metformin usually first choice medication to prescribe in T2DM?

A

Due to its ability to not affect weight gain

17
Q

What are contraindications you should check for with metformin?

A
  • Impaired renal function
  • Ketoacidosis
  • Low BMI
18
Q

How is metformin taken?

A

Once/Twice/Three times daily tablets - taken with meals

19
Q

How would you monitor metformin?

A

HbA1c - 3-6 months