Metformin Hydrochloride (Antidiabetic) Flashcards
What is the brand name of metformin hydrochloride?
Glucophage, Glumetza, Riomet
What is the brand name of metformin hydrochloride?
Glucophage, Glumetza, Riomet
What is the brand name of metformin hydrochloride?
Glucophage, Glumetza, Riomet
What is the brand name of metformin hydrochloride?
Glucophage, Glumetza, Riomet
What strength tablets of metformin are available?
500 mg, 850 mg, 1000 mg
What strength metformin extended release tablets are available?
500 mg, 750 mg, 1000 mg
Strength oral solution metformin is available
500 mg/5mL
What strength tablets of metformin are available?
500 mg, 850 mg, 1000 mg
What strength metformin extended release tablets are available?
500 mg, 750 mg, 1000 mg
What strength oral solution metformin is available?
500 mg/5mL (Riomet)
What is Glucophage indicated for?
Use as an adjunct to diet to lower blood glucose in patients with non-insulin dependent diabetes mellitus
What is the usual starting dose of Glumetza?
500mg tab BID w/ meals OR 850mg QD with morning meal
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
What is the maximum starting dose of metformin?
2550mg
How should Metformin XR be started?
start at 500mg QD with the evening meal
What is the maximum daily dose of Metformin XR?
2000mg
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
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
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.
What should be monitored for a patient on Glutmetza?
Fasting Blood Glucose, HbA-1c, RFT (Renal Function Test)
What is the relationship b/t metformin and food?
It should be taken with food.
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.
When should you stop treatment and notify your physician? (Metformin)
If you experience, unexplained hyperventilation, myalgia, malaise, or unusual somnolence
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.
What should the patient do in terms of water while taking Glucophage?
Stay well hydrated during therapy by drinking plenty of fluids
What are the adverse effects of metformin?
Decreased Vit B12 absorption, LACTIC ACIDOSIS, diarrhea, N&V, flatulence, anorexia, bloating, & an unpleasant metallic taste
Give more details on the adverse GI effects while taking metformin?
They are transient and disappear one the patient is stabilized.
Lactic acidosis is manifested by… (Metformin)
unexplained hyperventilation, myalgia, malaise, or unusual somnolence
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.
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
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)
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.
What is the relationship between metformin and cationic drugs eliminated by renal tubular secretion?
These drugs may increase metformin plasma levels
Use with what drugs can result in loss of glycemic control?(Metformin)
Use with drugs that may cause hyperglycemia
Metformin is a _________ which ____ glucose tolerance in NIDDM patients.
Metformin is a BIGUANIDE which IMPROVES glucose tolerance in NIDDM patients.
It _________ intestinal absorption of glucose, _________ hepatic gluconeogenesis, & ________ insulin sensitivity. (Metformin)
It DECREASES intestinal absorption of glucose, SUPPRESSES hepatic gluconeogenesis, & IMPROVES insulin sensitivity.
What must be present for metformin to be effective?
Endogenous insulin, even though it has no effect on B Cells
Unlike sulfonylureas, metformin does not…
cause hypoglycemia in either diabetic or non-diabetic patients
How can metformin tablets be found in the stool?
As a soft hydrated mass
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
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.
Metformin XR comprises a?
dual hydrophilic polymer matrix system.
Fluid from the GI tract enters… (Metformin)
enters the tablet and hydrates the polymers, causing them to swell.
How is metformin released?
Diffusion through a gel matrix independent of pH
How can metformin tablets be found in the stool?
As a soft hydrated mass
What strength tablets of metformin are available?
500 mg, 850 mg, 1000 mg
What strength metformin extended release tablets are available?
500 mg, 750 mg, 1000 mg
What strength oral solution metformin is available?
500 mg/5mL (Riomet)
What is Glucophage indicated for?
Use as an adjunct to diet to lower blood glucose in patients with non-insulin dependent diabetes mellitus
What is the usual starting dose of Glumetza?
500mg tab BID w/ meals OR 850mg QD with morning meal
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
What is the maximum starting dose of metformin?
2550mg
How should Metformin XR be started?
start at 500mg QD with the evening meal
What is the maximum daily dose of Metformin XR?
2000mg
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
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
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.
What should be monitored for a patient on Glutmetza?
Fasting Blood Glucose, HbA-1c, RFT (Renal Function Test)
What is the relationship b/t metformin and food?
It should be taken with food.
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.
When should you stop treatment and notify your physician? (Metformin)
If you experience, unexplained hyperventilation, myalgia, malaise, or unusual somnolence
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.
What should the patient do in terms of water while taking Glucophage?
Stay well hydrated during therapy by drinking plenty of fluids
What are the adverse effects of metformin?
Decreased Vit B12 absorption, LACTIC ACIDOSIS, diarrhea, N&V, flatulence, anorexia, bloating, & an unpleasant metallic taste
Give more details on the adverse GI effects while taking metformin?
They are transient and disappear one the patient is stabilized.
Lactic acidosis is manifested by… (Metformin)
unexplained hyperventilation, myalgia, malaise, or unusual somnolence
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.
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
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)
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.
What is the relationship between metformin and cationic drugs eliminated by renal tubular secretion?
These drugs may increase metformin plasma levels
Use with what drugs can result in loss of glycemic control?(Metformin)
Use with drugs that may cause hyperglycemia
Metformin is a _________ which ____ glucose tolerance in NIDDM patients.
Metformin is a BIGUANIDE which IMPROVES glucose tolerance in NIDDM patients.
It _________ intestinal absorption of glucose, _________ hepatic gluconeogenesis, & ________ insulin sensitivity. (Metformin)
It DECREASES intestinal absorption of glucose, SUPPRESSES hepatic gluconeogenesis, & IMPROVES insulin sensitivity.
What must be present for metformin to be effective?
Endogenous insulin, even though it has no effect on B Cells
Unlike sulfonylureas, metformin does not…
cause hypoglycemia in either diabetic or non-diabetic patients
When are steady state plasma levels reached? (Metformin)
24-48 hours
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
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.
Metformin XR comprises a?
dual hydrophilic polymer matrix system.
Fluid from the GI tract enters… (Metformin)
enters the tablet and hydrates the polymers, causing them to swell.
How is metformin released?
Diffusion through a gel matrix independent of pH
How can metformin tablets be found in the stool?
As a soft hydrated mass
What strength tablets of metformin are available?
500 mg, 850 mg, 1000 mg
What strength metformin extended release tablets are available?
500 mg, 750 mg, 1000 mg
What strength oral solution metformin is available?
500 mg/5mL (Riomet)
What is Glucophage indicated for?
Use as an adjunct to diet to lower blood glucose in patients with non-insulin dependent diabetes mellitus
What is the usual starting dose of Glumetza?
500mg tab BID w/ meals OR 850mg QD with morning meal
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
What is the maximum starting dose of metformin?
2550mg
How should Metformin XR be started?
start at 500mg QD with the evening meal
What is the maximum daily dose of Metformin XR?
2000mg
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
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
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.
What should be monitored for a patient on Glutmetza?
Fasting Blood Glucose, HbA-1c, RFT (Renal Function Test)
What is the relationship b/t metformin and food?
It should be taken with food.
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.
When should you stop treatment and notify your physician? (Metformin)
If you experience, unexplained hyperventilation, myalgia, malaise, or unusual somnolence
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.
What should the patient do in terms of water while taking Glucophage?
Stay well hydrated during therapy by drinking plenty of fluids
What are the adverse effects of metformin?
Decreased Vit B12 absorption, LACTIC ACIDOSIS, diarrhea, N&V, flatulence, anorexia, bloating, & an unpleasant metallic taste
Give more details on the adverse GI effects while taking metformin?
They are transient and disappear one the patient is stabilized.
Lactic acidosis is manifested by… (Metformin)
unexplained hyperventilation, myalgia, malaise, or unusual somnolence
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.
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
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)
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.
What is the relationship between metformin and cationic drugs eliminated by renal tubular secretion?
These drugs may increase metformin plasma levels
Use with what drugs can result in loss of glycemic control?(Metformin)
Use with drugs that may cause hyperglycemia
Metformin is a _________ which ____ glucose tolerance in NIDDM patients.
Metformin is a BIGUANIDE which IMPROVES glucose tolerance in NIDDM patients.
It _________ intestinal absorption of glucose, _________ hepatic gluconeogenesis, & ________ insulin sensitivity. (Metformin)
It DECREASES intestinal absorption of glucose, SUPPRESSES hepatic gluconeogenesis, & IMPROVES insulin sensitivity.
What must be present for metformin to be effective?
Endogenous insulin, even though it has no effect on B Cells
Unlike sulfonylureas, metformin does not…
cause hypoglycemia in either diabetic or non-diabetic patients
When are steady state plasma levels reached? (Metformin)
24-48 hours
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
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.
Metformin XR comprises a?
dual hydrophilic polymer matrix system.
Fluid from the GI tract enters… (Metformin)
enters the tablet and hydrates the polymers, causing them to swell.
How is metformin released?
Diffusion through a gel matrix independent of pH
How can metformin tablets be found in the stool?
As a soft hydrated mass
