* After studying this topic, attempt a test on METFORMIN under the category ‘TEST FOR YOU: TOPIC-WISE on the TEST PACKAGES page.
This blog prepares you for
GPAT
D.Pharm, B.Pharm, and Pharm.D. (Pharmacy Exams)
RRB Pharmacist Recruitment Exam
Common Recruitment Examination for AIIMS Pharmacist
KGMU Pharmacist Recruitment Exam
KSSSCI Pharmacist Recruitment Exam
MPESB Pharmacist Recruitment Exam
Drugs Inspector Exams
Drugs Controller Exams
DPEE
Medical and Nursing Exams
Metformin is recommended as the first line treatment in type 2 diabetes in adult and pediatric patients 10 years and older.
Metformin belongs to biguanide class of oral hypoglycaemic agent.
Metformin decreases hepatic gluconeogenesis production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. It does not stimulate insulin secretion.
As monotherapy, it rarely produces hypoglycaemia.
The recommended starting daily dose is 500 mg after meals, which is increased by 500 mg every two weeks until desired therapeutic goals are achieved or maximum daily doses (2500 mg) are reached.
The usual daily dosage range for Metformin SR is 500 mg to 2000 mg, taken once or twice a day.
It can be used in combination with any other oral or injectable anti-hyperglycaemic agents.
Metformin is quickly absorbed from the small intestine. Bioavailability is from 50% to 60%, and the drug is not protein bound.
Metformin is excreted as unmetabolized drug in the urine, via tubular excretion.
It is advisable to stop metformin at least 24 hours before major surgery or use of radio contrast media.
Its adverse reaction includes lactic acidosis, megaloblastic anemia, diarrhea, myalgia, abdominal pain, Vitamin B12 deficiency, etc.
Monitoring of blood glucose levels as an effect of metformin can be easily done hence therapeutic drug monitoring is not required for metformin.
Metformin is contraindicated in patients with metabolic acidosis.
Generally avoid metformin use in hepatic impairment; hepatic disease increases the risk of metformin-associated lactic acidosis.
Symptoms of overdosage include lactic acidosis manifested as malaise, myalgia, respiratory distress, increasing somnolence and abdominal distress.
Drug interactions include I) Increased risk of lactic acidosis with carbonic anhydrase inhibitors, NSAIDs, ACE inhibitors, angiotensin II receptor antagonists and loop diuretics. II) Competitive inhibition of renal excretion of metformin by cimetidine, which can lead to increased metformin blood levels.
Phenformin and buformin are derivatives of metformin. These two drugs were withdrawn from the market due to toxic lactic acidosis effects and an increased incidence of cardiac mortality.
Metformin is often a second-line treatment for menstrual irregularity in PCOS patients, particularly those who are unable to take or tolerate combined oral contraceptives, or those who have insulin resistance.
It is a white crystalline powder, almost odourless, freely soluble in water and less in alcohol. It is hygroscopic in nature.
Storage: It is hygroscopic in nature and so it is stored in a tightly closed container.
Some popular brand names of metformin are Metformin, Glycomet, Glyciphage, Diabex, Diaformin, DMGG.
MCQs
1. Which of the following antidiabetic drug (oral) does not stimulate insulin secretion?
a) Metformin
b) Nateglinide
c) Repaglinide
d) Glyburide
2. Which of the following are common side effects of Metformin?
a) Diarrhea, mild gastrointestinal distress, and lactic acidosis
b) Nausea, severe abdominal pain, and hypertension
c) Dizziness, skin rash, and liver failure
d) Weight gain, dizziness, and hyperglycemia
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Blog content and MCQs have been taken from the following:
1) Essential Pharmacy Review for Drugs Inspector Exams by Nirali Prakashan, Pune
To know more about the book:
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2) Pharmacist Recruitment Exam by Nirali Prakashan, Pune
To know more about the book:
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PHARMACOLOGY (Second Year Diploma in Pharmacy PCI – ER 2020)
Authors: Sunil R. Bakliwal , Praneta R. Desale , Pravin P. Jawale
This book includes more than 500 MCQs for the preparation of DPEE and various Pharmacist Recruitment Exams
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