treatment of 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)
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
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.
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.
Cardiopulmonary, hepatic, or renal insufficiency
Acute myocardial infarction
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.