Metformin DI

Question 1

Metformin primary MoA

Answer 1

Decrease glucose output from liver

Question 2

Metformin secondary MoA

Answer 2

Increase peripheral muscle glucose sensitivity

Question 3

Metformin brand names

Answer 3

Glucophage, Fortamet

Question 4

Metformin dosing

Answer 4

Ideal dose is 2,000mg PO QD, but adjust to 1,000mg PO QD if eGFR 30-45 mL/min

Question 5

Metformin side effects

Answer 5

N/V, lactic acidosis (rare), abdominal discomfort, diarrhea, weight loss

Question 6

Metformin DI

Answer 6

Contrast dye- hold 24 hrs before procedure and for another 48 hrs after that

Question 7

Metformin counseling

Answer 7

Start low and go slow, take with food to avoid GI upset, avoid alcohol, stop in sick day management

Question 8

What should you ask about at metformin refills?

Answer 8

Lactic acidosis, weight loss, GI upset

Question 9

Metformin pearls

Answer 9

High A1C lowering, potential benefit in ASCVD, but neutral effects on HF and CKD

Question 10

Metformin monitoring

Answer 10

A1C, FBG/PPG, eGFR, B12 levels, weight loss, LA

Question 11

Peak effect of metformin

Answer 11

6-8 weeks

Question 12

Metformin in ADA and AACE guidelines

Answer 12

1st line in both!