METFORMIN

Question 1

Drug class

Answer 1

biguanides

Question 2

How does it work? (3)

Answer 2

1. increases the response to insulin
2. by suppressing hepatic glucose production, increasing glucose reuptake and use as an energy source
3. this is all by a complex intracellular mechanism

Question 3

Indications

Answer 3

1. type 2 diabetes

Question 4

Contra-indications (3)

Answer 4

1. kidneys

• severe renal impairment
• moderate renal impairment –> dose reduction
• AKI

2. liver
   - acute alcohol intoxication
   - chronic alcohol overuse
   - hepatic impairment
3. tissues
   - hypoxia

Question 5

Side effects (2)

Answer 5

1. GI upset
2. lactic acidosis

DON’T CAUSE HYPOGLYCAEMIA

Question 6

Interactions (3)

Answer 6

1. IV contrasted CT
2. Nephrotoxic drugs

• ACEIs
• Furosemide
• NSAIDs

3. drugs that elevate glucose
   e. g. prednisolone

Question 7

Elimination

Answer 7

urine