Metformin Hydrochloride (Antidiabetic) Flashcards
1
Q
What is the brand name of metformin hydrochloride?
A
Glucophage, Glumetza, Riomet
2
Q
What is the brand name of metformin hydrochloride?
A
Glucophage, Glumetza, Riomet
3
Q
What is the brand name of metformin hydrochloride?
A
Glucophage, Glumetza, Riomet
4
Q
What is the brand name of metformin hydrochloride?
A
Glucophage, Glumetza, Riomet
5
Q
What strength tablets of metformin are available?
A
500 mg, 850 mg, 1000 mg
6
Q
What strength metformin extended release tablets are available?
A
500 mg, 750 mg, 1000 mg
7
Q
Strength oral solution metformin is available
A
500 mg/5mL
8
Q
What strength tablets of metformin are available?
A
500 mg, 850 mg, 1000 mg
9
Q
What strength metformin extended release tablets are available?
A
500 mg, 750 mg, 1000 mg
10
Q
What strength oral solution metformin is available?
A
500 mg/5mL (Riomet)
11
Q
What is Glucophage indicated for?
A
Use as an adjunct to diet to lower blood glucose in patients with non-insulin dependent diabetes mellitus
12
Q
What is the usual starting dose of Glumetza?
A
500mg tab BID w/ meals OR 850mg QD with morning meal
13
Q
How should the dose be increased for metformin?
A
Gradually increase dose by adding one 500mg tab every weeks or one 850mg tab QO week until the optimum response is seen
14
Q
What is the maximum starting dose of metformin?
A
2550mg
15
Q
How should Metformin XR be started?
A
start at 500mg QD with the evening meal
16
Q
What is the maximum daily dose of Metformin XR?
A
2000mg
17
Q
Can patients be switched from metformin to metformin XR?
A
yes, they can be switched from the same daily dose metformin to metformin XR up to 2000mg
18
Q
What is the relationship of use between metformin and sulfonylurea drugs?
A
They can be used continuously together when diet and metformin or a sulfonylurea alone do not result in adequate glycemic control
19
Q
What is the transition period from other hypoglycemic agents to metformin?
A
No transition period is needed when transferring patients from moth other hypoglycemic agents. Due to chlorpropamide’s long half-life, particular care should be exercised during the first 2 weeks when transferring from chlorpropamide therapy.
20
Q
What should be monitored for a patient on Glutmetza?
A
Fasting Blood Glucose, HbA-1c, RFT (Renal Function Test)
21
Q
What is the relationship b/t metformin and food?
A
It should be taken with food.
22
Q
What is the relationship between alcohol and metformin?
A
Avoid excessive alcohol consumption during treatment. This includes drinking alcohol all the time or binge drinking for short periods.
23
Q
When should you stop treatment and notify your physician? (Metformin)
A
If you experience, unexplained hyperventilation, myalgia, malaise, or unusual somnolence
24
Q
What should one do if they miss a dose?
A
If more than a couple hours have passed, skip that dose. DO NOT double up one doses.
25
What should the patient do in terms of water while taking Glucophage?
Stay well hydrated during therapy by drinking plenty of fluids
26
What are the adverse effects of metformin?
Decreased Vit B12 absorption, LACTIC ACIDOSIS, diarrhea, N&V, flatulence, anorexia, bloating, & an unpleasant metallic taste
27
Give more details on the adverse GI effects while taking metformin?
They are transient and disappear one the patient is stabilized.
28
Lactic acidosis is manifested by... (Metformin)
unexplained hyperventilation, myalgia, malaise, or unusual somnolence
29
What is the Black Box warning for metformin?
METFORMIN MAY CAUSE LACTIC ACIDOSIS RESULTING IN DEATH, HYPOTHERMIA, HYPOTENSION, AND RESISTANT BRADYARRHYTHMIAS. RISK FACTORS INCLUDE ADVANCED AGE, RADIOLOGICAL STUDIES WITH CONTRAST, SURGERY HYPOXIC STATES, EXCESSIVE ALCOHOL USE, AND HEPATIC IMPAIRMENT.
30
What are the contraindication for metformin HCl?
Contraindicated in patients with impaired renal function (serum creatinine greater than or equal to 1.5mg/dL) and those with impaired hepatic function
31
When should the patient temporarily DC therapy? (Metformin)
when undergoing radiologic studies involving parenteral administration of iodized contracts material (due to its effects on renal function)
32
What drug interactions are known for metformin hydrochloride?
furosemide, cimetidine, & nifedipine may increase plasma levels. Alcohol may potentiate the effect of metformin on lactation metabolism.
33
What is the relationship between metformin and cationic drugs eliminated by renal tubular secretion?
These drugs may increase metformin plasma levels
34
Use with what drugs can result in loss of glycemic control?(Metformin)
Use with drugs that may cause hyperglycemia
35
Metformin is a _________ which ____ glucose tolerance in NIDDM patients.
Metformin is a BIGUANIDE which IMPROVES glucose tolerance in NIDDM patients.
36
It _________ intestinal absorption of glucose, _________ hepatic gluconeogenesis, & ________ insulin sensitivity. (Metformin)
It DECREASES intestinal absorption of glucose, SUPPRESSES hepatic gluconeogenesis, & IMPROVES insulin sensitivity.
37
What must be present for metformin to be effective?
Endogenous insulin, even though it has no effect on B Cells
38
Unlike sulfonylureas, metformin does not...
cause hypoglycemia in either diabetic or non-diabetic patients
39
How can metformin tablets be found in the stool?
As a soft hydrated mass
40
How is metformin excreted and what is its half-life?
It is excreted entirely by renal excretion and has a half-life of about 6 hours
41
There is a lack of ____________ with increasing doses for both metformin and metformin XR.
There is a lack of DOSE PROPORTIONALITY with increasing doses for both metformin and metformin XR.
42
Metformin XR comprises a?
dual hydrophilic polymer matrix system.
43
Fluid from the GI tract enters... (Metformin)
enters the tablet and hydrates the polymers, causing them to swell.
44
How is metformin released?
Diffusion through a gel matrix independent of pH
45
How can metformin tablets be found in the stool?
As a soft hydrated mass
46
What strength tablets of metformin are available?
500 mg, 850 mg, 1000 mg
47
What strength metformin extended release tablets are available?
500 mg, 750 mg, 1000 mg
48
What strength oral solution metformin is available?
500 mg/5mL (Riomet)
49
What is Glucophage indicated for?
Use as an adjunct to diet to lower blood glucose in patients with non-insulin dependent diabetes mellitus
50
What is the usual starting dose of Glumetza?
500mg tab BID w/ meals OR 850mg QD with morning meal
51
How should the dose be increased for metformin?
Gradually increase dose by adding one 500mg tab every weeks or one 850mg tab QO week until the optimum response is seen
52
What is the maximum starting dose of metformin?
2550mg
53
How should Metformin XR be started?
start at 500mg QD with the evening meal
54
What is the maximum daily dose of Metformin XR?
2000mg
55
Can patients be switched from metformin to metformin XR?
yes, they can be switched from the same daily dose metformin to metformin XR up to 2000mg
56
What is the relationship of use between metformin and sulfonylurea drugs?
They can be used continuously together when diet and metformin or a sulfonylurea alone do not result in adequate glycemic control
57
What is the transition period from other hypoglycemic agents to metformin?
No transition period is needed when transferring patients from moth other hypoglycemic agents. Due to chlorpropamide's long half-life, particular care should be exercised during the first 2 weeks when transferring from chlorpropamide therapy.
58
What should be monitored for a patient on Glutmetza?
Fasting Blood Glucose, HbA-1c, RFT (Renal Function Test)
59
What is the relationship b/t metformin and food?
It should be taken with food.
60
What is the relationship between alcohol and metformin?
Avoid excessive alcohol consumption during treatment. This includes drinking alcohol all the time or binge drinking for short periods.
61
When should you stop treatment and notify your physician? (Metformin)
If you experience, unexplained hyperventilation, myalgia, malaise, or unusual somnolence
62
What should one do if they miss a dose?
If more than a couple hours have passed, skip that dose. DO NOT double up one doses.
63
What should the patient do in terms of water while taking Glucophage?
Stay well hydrated during therapy by drinking plenty of fluids
64
What are the adverse effects of metformin?
Decreased Vit B12 absorption, LACTIC ACIDOSIS, diarrhea, N&V, flatulence, anorexia, bloating, & an unpleasant metallic taste
65
Give more details on the adverse GI effects while taking metformin?
They are transient and disappear one the patient is stabilized.
66
Lactic acidosis is manifested by... (Metformin)
unexplained hyperventilation, myalgia, malaise, or unusual somnolence
67
What is the Black Box warning for metformin?
METFORMIN MAY CAUSE LACTIC ACIDOSIS RESULTING IN DEATH, HYPOTHERMIA, HYPOTENSION, AND RESISTANT BRADYARRHYTHMIAS. RISK FACTORS INCLUDE ADVANCED AGE, RADIOLOGICAL STUDIES WITH CONTRAST, SURGERY HYPOXIC STATES, EXCESSIVE ALCOHOL USE, AND HEPATIC IMPAIRMENT.
68
What are the contraindication for metformin HCl?
Contraindicated in patients with impaired renal function (serum creatinine greater than or equal to 1.5mg/dL) and those with impaired hepatic function
69
When should the patient temporarily DC therapy? (Metformin)
when undergoing radiologic studies involving parenteral administration of iodized contracts material (due to its effects on renal function)
70
What drug interactions are known for metformin hydrochloride?
furosemide, cimetidine, & nifedipine may increase plasma levels. Alcohol may potentiate the effect of metformin on lactation metabolism.
71
What is the relationship between metformin and cationic drugs eliminated by renal tubular secretion?
These drugs may increase metformin plasma levels
72
Use with what drugs can result in loss of glycemic control?(Metformin)
Use with drugs that may cause hyperglycemia
73
Metformin is a _________ which ____ glucose tolerance in NIDDM patients.
Metformin is a BIGUANIDE which IMPROVES glucose tolerance in NIDDM patients.
74
It _________ intestinal absorption of glucose, _________ hepatic gluconeogenesis, & ________ insulin sensitivity. (Metformin)
It DECREASES intestinal absorption of glucose, SUPPRESSES hepatic gluconeogenesis, & IMPROVES insulin sensitivity.
75
What must be present for metformin to be effective?
Endogenous insulin, even though it has no effect on B Cells
76
Unlike sulfonylureas, metformin does not...
cause hypoglycemia in either diabetic or non-diabetic patients
77
When are steady state plasma levels reached? (Metformin)
24-48 hours
78
How is metformin excreted and what is its half-life?
It is excreted entirely by renal excretion and has a half-life of about 6 hours
79
There is a lack of ____________ with increasing doses for both metformin and metformin XR.
There is a lack of DOSE PROPORTIONALITY with increasing doses for both metformin and metformin XR.
80
Metformin XR comprises a?
dual hydrophilic polymer matrix system.
81
Fluid from the GI tract enters... (Metformin)
enters the tablet and hydrates the polymers, causing them to swell.
82
How is metformin released?
Diffusion through a gel matrix independent of pH
83
How can metformin tablets be found in the stool?
As a soft hydrated mass
84
What strength tablets of metformin are available?
500 mg, 850 mg, 1000 mg
85
What strength metformin extended release tablets are available?
500 mg, 750 mg, 1000 mg
86
What strength oral solution metformin is available?
500 mg/5mL (Riomet)
87
What is Glucophage indicated for?
Use as an adjunct to diet to lower blood glucose in patients with non-insulin dependent diabetes mellitus
88
What is the usual starting dose of Glumetza?
500mg tab BID w/ meals OR 850mg QD with morning meal
89
How should the dose be increased for metformin?
Gradually increase dose by adding one 500mg tab every weeks or one 850mg tab QO week until the optimum response is seen
90
What is the maximum starting dose of metformin?
2550mg
91
How should Metformin XR be started?
start at 500mg QD with the evening meal
92
What is the maximum daily dose of Metformin XR?
2000mg
93
Can patients be switched from metformin to metformin XR?
yes, they can be switched from the same daily dose metformin to metformin XR up to 2000mg
94
What is the relationship of use between metformin and sulfonylurea drugs?
They can be used continuously together when diet and metformin or a sulfonylurea alone do not result in adequate glycemic control
95
What is the transition period from other hypoglycemic agents to metformin?
No transition period is needed when transferring patients from moth other hypoglycemic agents. Due to chlorpropamide's long half-life, particular care should be exercised during the first 2 weeks when transferring from chlorpropamide therapy.
96
What should be monitored for a patient on Glutmetza?
Fasting Blood Glucose, HbA-1c, RFT (Renal Function Test)
97
What is the relationship b/t metformin and food?
It should be taken with food.
98
What is the relationship between alcohol and metformin?
Avoid excessive alcohol consumption during treatment. This includes drinking alcohol all the time or binge drinking for short periods.
99
When should you stop treatment and notify your physician? (Metformin)
If you experience, unexplained hyperventilation, myalgia, malaise, or unusual somnolence
100
What should one do if they miss a dose?
If more than a couple hours have passed, skip that dose. DO NOT double up one doses.
101
What should the patient do in terms of water while taking Glucophage?
Stay well hydrated during therapy by drinking plenty of fluids
102
What are the adverse effects of metformin?
Decreased Vit B12 absorption, LACTIC ACIDOSIS, diarrhea, N&V, flatulence, anorexia, bloating, & an unpleasant metallic taste
103
Give more details on the adverse GI effects while taking metformin?
They are transient and disappear one the patient is stabilized.
104
Lactic acidosis is manifested by... (Metformin)
unexplained hyperventilation, myalgia, malaise, or unusual somnolence
105
What is the Black Box warning for metformin?
METFORMIN MAY CAUSE LACTIC ACIDOSIS RESULTING IN DEATH, HYPOTHERMIA, HYPOTENSION, AND RESISTANT BRADYARRHYTHMIAS. RISK FACTORS INCLUDE ADVANCED AGE, RADIOLOGICAL STUDIES WITH CONTRAST, SURGERY HYPOXIC STATES, EXCESSIVE ALCOHOL USE, AND HEPATIC IMPAIRMENT.
106
What are the contraindication for metformin HCl?
Contraindicated in patients with impaired renal function (serum creatinine greater than or equal to 1.5mg/dL) and those with impaired hepatic function
107
When should the patient temporarily DC therapy? (Metformin)
when undergoing radiologic studies involving parenteral administration of iodized contracts material (due to its effects on renal function)
108
What drug interactions are known for metformin hydrochloride?
furosemide, cimetidine, & nifedipine may increase plasma levels. Alcohol may potentiate the effect of metformin on lactation metabolism.
109
What is the relationship between metformin and cationic drugs eliminated by renal tubular secretion?
These drugs may increase metformin plasma levels
110
Use with what drugs can result in loss of glycemic control?(Metformin)
Use with drugs that may cause hyperglycemia
111
Metformin is a _________ which ____ glucose tolerance in NIDDM patients.
Metformin is a BIGUANIDE which IMPROVES glucose tolerance in NIDDM patients.
112
It _________ intestinal absorption of glucose, _________ hepatic gluconeogenesis, & ________ insulin sensitivity. (Metformin)
It DECREASES intestinal absorption of glucose, SUPPRESSES hepatic gluconeogenesis, & IMPROVES insulin sensitivity.
113
What must be present for metformin to be effective?
Endogenous insulin, even though it has no effect on B Cells
114
Unlike sulfonylureas, metformin does not...
cause hypoglycemia in either diabetic or non-diabetic patients
115
When are steady state plasma levels reached? (Metformin)
24-48 hours
116
How is metformin excreted and what is its half-life?
It is excreted entirely by renal excretion and has a half-life of about 6 hours
117
There is a lack of ____________ with increasing doses for both metformin and metformin XR.
There is a lack of DOSE PROPORTIONALITY with increasing doses for both metformin and metformin XR.
118
Metformin XR comprises a?
dual hydrophilic polymer matrix system.
119
Fluid from the GI tract enters... (Metformin)
enters the tablet and hydrates the polymers, causing them to swell.
120
How is metformin released?
Diffusion through a gel matrix independent of pH
121
How can metformin tablets be found in the stool?
As a soft hydrated mass
