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DM2 Biguanides-Metformin (Glucophage) Cheat Sheet by

treatment of type 2 diabetes mellitus

Medication Names

Metformin
Glucophage

Therap­eutic Use

Type 2 diabetes mellitus

Adverse Drug Reactions

Lactic acidosis (rare, but potent­ially fatal)
Nausea, diarrhea, vomiting
Unpleasant metallic taste
Vitamin defici­encies (vitamin B12, folic acid)

Interv­entions

Monitor for indica­tions of lactic acidosis.
For signs of lactic acidosis, stop drug therapy immedi­ately.
Expect that severe lactic acidosis will require hemodi­alysis.
Monitor for persistent nausea, vomiting, or diarrhea
Monitor fluid intake and output.
Monitor for indica­tions of vitamin B12 or folic acid defici­ency.
Recommend the approp­riate supple­ments.
Monitor renal function upon initial therapy and yearly afterward

Precau­tions

Diarrhea, Dehydr­ation
Anemia
Pituitary insuff­iciency
Gastro­paresis
Gastro­int­estinal obstru­ction.
Hypert­hyr­oidism
Older adults
 

Drug Admini­str­ation

Give orally twice a day with the morning and evening meals (immedi- ate-re­lease) or once a day with the evening meal (exten­ded­-re­lease)
Make sure clients swallow the extend­ed-­release form whole and do not crush or chew it.

Patient Education

Avoid drinking alcohol.
Report weakness, fatigue, lethargy, or hyperv­ent­ila­tion.
If these symptoms develop, stop taking the drug and seek medical care immedi­ately
Expect these effects to diminish as drug therapy continues
Lie down when feeling nauseated
Maintain adequate carboh­ydrate and fluid intak
Report weakness, fatigue, pallor, or reddened tongue.

Contra­ind­ica­tions

Diabetic ketoac­idosis
Cardio­pul­monary, hepatic, or renal insuff­iciency
Alcoholism
Heart failure
Severe infection
Shock
Acute myocardial infarction
Hypoxemia
Lactic acidosis

Intera­ctions

Alcohol and cimetidine (Tagamet) increase the risk of lactic acidosis.
Any contrast medium containing iodine increases the risk of acute renal failure, thus worsening lactic acidosis
Nifedipine (Proca­rdia), furosemide (Lasix), morphine, antifu­ngals, and many other drugs increase hypogl­ycemic effects.
 

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  • Published: 25th March, 2022

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