Metformin

dr.joandr.joan عضو ماسي
تم تعديل 2009/07/02 في أدوية الطوارئ Emergency drugs
Metformin :
Trade names: Glucophage
Class: antidiabetics ,biguanides
Pregnancy: (Category B)
Action:
· Decreases hepatic production of glucose
· Decreases intestinal absorption of glucose
· Increases sensitivity to insulin.
Uses:
  • Adjunctive management type 2 diabetes mellitus. May be used with diet and/or sulfonylurea oral hypoglycemic agents.
Dose:
initially 500 mg with breakfast for at least 1 week
then 500 mg with breakfast and evening meal for at least 1 week
then 500 mg with breakfast, lunch and evening meal;
max. 3 g daily in divided doses but most physicians limit this to 2 g daily
Contraindications:
Hypersensitivity
Metabolic acidosis of any cause
Dehydration, sepsis, hypoxemia, impaired hepatic function, excessive alcohol ingestion (acute or chronic)
Underlying renal dysfunction (serum creatinine >1.5 mg/dl in men or >1.4 mg/dl in women)
Concurrent radiographic studies requiring IV administration of iodinated contrast media (temporarily withhold metformin)
CHF requiring pharmacologic treatment.
Side effects:
GI: abdominal bloating, diarrhea, nausea, vomiting, unpleasant metallic taste.
Endo: hypoglycemia.
F and E: LACTIC ACIDOSIS.
Misc: decreased vitamin B12 levels.

Nursing considerations:
Drugs may be taken with food to minimize GI upset.
Stop the medication if signs of side-effects or ketoacidosis appear.
Check for early symptoms of hypoglycemia.
Assess diabetic more closely for infection or emotional disturbances that may increase insulin requirements.
Explain the necessity for close regular medical supervision.
Explain to patient how to test the urine for sugar & acetone.
Explain the use & care of equipment & the storage of medication.
Explain the importance of exercise & adhering to the prescribed diet.
Explain the importance of carrying candy or sugar at all times to counteract
hypoglycemia should it occur.
Provide the client & family with a printed chart explaining symptoms of hypoglycemia , hyperglycemia & instructions concerning what to do for each.