Meformin Drug Study

In making a Drug Study, the following elements must be present: Generic Name and the Brand name (not all brands, just the brand used by the patient), Action, Indication, Pregnancy Category, Drug Classification, and Contraindication, Adverse Effect, Drug interaction and Nursing Consideration/Intervention…. Most clinical instructors preferred this to be in a long bond paper in printed or handwritten with paper in landscape.

Metformin hydrochloride

Brand Name: Glucophage, Glucophage XR

Pregnancy Category B

Drug class: Antidiabetic agent

Therapeutic actions

Exact mechanism is not understood; possibly increases peripheral utilization of glucose, increases production of insulin, decreases hepatic glucose production and alters intestinal absorption of glucose.

Indications

· Adjunct to diet to lower blood glucose with non–insulin-dependent diabetes mellitus (type 2) in patients > 10 yr; extended release > 17 yr.

· As part of combination therapy with a sulfonylurea or insulin when either drug alone cannot control glucose levels in patients with non–insulin-dependent diabetes mellitus

Contraindications

· Allergy to metformin; CHF; diabetes complicated by fever, severe infections, severe trauma, major surgery, ketosis, acidosis, coma (use insulin); type 1 or juvenile diabetes, serious hepatic impairment, serious renal impairment, uremia, thyroid or endocrine impairment, glycosuria, hyperglycemia associated with primary renal disease; labor and delivery--if metformin is used during pregnancy, discontinue drug at least 1 mo before delivery; lactation, safety not established.

Adverse effects

· Endocrine: Hypoglycemia, lactic acidosis

· GI: Anorexia, nausea, vomiting, epigastric discomfort, heartburn, diarrhea

· Hypersensitivity: Allergic skin reactions, eczema, pruritus, erythema, urticaria

Drug Interactions:

· Increased risk of hypoglycemia with cimetidine, furosemide, cationic drugs such as digoxin, amiloride, vancomycin

· Increased risk of lactic acidosis with glucocorticoids or ethanol

· Increased risk of acute renal failure and lactic acidosis with iodinated contrast material used in radiologic studies; stop metformin for 48 hr before and after such studies

Nursing considerations

· Monitor urine or serum glucose levels frequently to determine effectiveness of drug and dosage.

· Arrange for transfer to insulin therapy during periods of high stress (infections, surgery, trauma).

· Use IV glucose if severe hypoglycemia occurs as a result of overdose.