Questions and Answers
What is the therapeutic class of metformin (Glucophage)?
What is the pharmacologic class of metformin (Glucophage)?
What is one indication for the use of metformin (Glucophage)?
Type 2 diabetes management
Which of the following is a mechanism of action for metformin (Glucophage)?
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What is one of the major side effects of metformin (Glucophage)?
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What is the usual adult dosage of metformin (Glucophage)?
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Name one nursing intervention related to metformin (Glucophage).
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What should be monitored during long-term therapy with metformin (Glucophage)?
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Symptoms of lactic acidosis do not need to be reported immediately.
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Study Notes
Metformin (Glucophage) Overview
- Therapeutic class: antidiabetic
- Pharmacologic class: biguanides
Indications and Mechanism of Action
- Used for managing Type 2 diabetes.
- Mechanism of action includes:
- Decreasing hepatic glucose production.
- Reducing intestinal glucose absorption.
- Increasing insulin sensitivity.
- Therapeutic effects: maintains blood glucose levels.
Side Effects
- Major side effects include:
- Gastrointestinal: abdominal bloating, diarrhea, nausea, vomiting, and an unpleasant metallic taste.
- Electrolyte imbalance risk: lactic acidosis.
- Miscellaneous: may decrease vitamin B12 levels.
Adult Dosage Parameters
- Oral dosage for adults and children over 17 years:
- Start with 500 mg twice daily, may increase by 500 mg weekly up to 2000 mg/day.
- For doses over 2000 mg/day, administer in 3 divided doses (max 2500 mg/day) or 850 mg once daily, increasing as needed.
- Extended-release: 500-1000 mg once daily with evening meal, can increase by 500 mg weekly to a maximum of 2500 mg once daily.
Nursing Interventions
- Assess patients with illness for signs of ketoacidosis or lactic acidosis:
- Check serum electrolytes, ketones, glucose, and relevant blood levels.
- Discontinue metformin if acidosis is present.
- Monitor renal function before starting and annually during treatment; discontinue if renal impairment occurs.
- Watch serum folic acid and vitamin B12 levels every 1-2 years due to absorption interference.
- Patients under stress (fever, trauma, infection, surgery) may need insulin; suspend metformin temporarily.
- Educate patients on lactic acidosis risks and the need for discontinuation during severe conditions.
- Review signs of hypoglycemia and hyperglycemia with patients; provide guidance on managing hypoglycemic episodes.
- Instruct patients on blood glucose and urine ketone testing, especially during illness or stress.
Important Notes and Considerations
- Symptoms of lactic acidosis must be reported immediately; include chills, diarrhea, dizziness, low blood pressure, muscle pain, sleepiness, slow heartbeat, dyspnea, or weakness.
- Assess renal function and monitor liver function tests (LFTs), creatinine, serum folic acid, and B12 levels regularly.
- In cases where metformin is combined with iodine contrast, hold the medication on the imaging day and for 48 hours afterwards to prevent kidney damage.
- Extended-release tablets should be swallowed whole without chewing.
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Description
Test your knowledge on Metformin (Glucophage) with these flashcards. Covering its therapeutic and pharmacologic classes, indications, mechanisms of action, and therapeutic effects, this quiz provides a comprehensive review for anyone studying diabetes management.
