Metformin: Uses, actions, main adverse effects: Flashcards
What is the administration route for metformin?
Oral tablets
What are the 2 forms of the metformin tablet?
Immediate release
Moderate release
Which 2 conditions is metformin the first-line drug for?
Type 2 diabetes
Gestational diabetes
Which 5 conditions can be treated by unlicensed use of metformin?
PCOS
Obesity
Prediabetes
Prevention of pregnancy complications
Infertility
What is the main mechanism of action of metformin?
Inhibits hepatic glycogenolysis and gluconeogenesis (part of glucose synthesis pathway)
What mechanism of action of metformin specifically targets muscle and fat cells?
Increases insulin sensitivity
Why is high insulin sensitivity important for regulating blood glucose levels, and what metabolic pathway is mainly involved?
High insulin sensitivity allows cells to respond to insulin and initiate insulin transduction pathway
which causes glucose uptake in cells and reduces glucose synthesis in liver
What mechanism of action of metformin targets the intestines?
Reduces intestinal absorption of glucose
Which body system is mainly affected by metformin side effects?
Gastrointestinal
Give 4 common GI side effects of metformin?
Nausea and vomiting
Diarrhoea
Abdominal pain
Altered taste
How are the GI side effects of metformin treated?
They are not as they should resolve spontaneously
What are the main 3 ways in which a patient’s administration of metformin can be adapted to relieve GI side effects?
Slowly increase dose over time
Take tablet with meal
Use modified release tablet
What deficiency can be caused by long-term metformin therapy, and how can this be prevented?
Vitamin B12 deficiency
Have regular vitamin B12 level monitoring
What are the 3 main rare side effects of metformin?
Lactic acidosis
Skin reactions
Hepatitis
