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Metformin (Fortamet/Glucophage) Nursing Drug Card (Simplified) – Pharmacology

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NCLEX Review: Metformin (Oral antidiabetic, Biguanide) – Mechanism of Action, Uses, Side effects, Contraindications, and Nursing considerations

Hey everyone this is nurse ryan and today we’re going to be talking about the drug metformin also known by the brand names fordimet glucophage and more you can use the timestamps in the video description to jump ahead metformin belongs to the by guanide drug classification which is a type of anti-diabetic metformin is most often used in the management of type

2 diabetes before we get into how metformin works let’s do a quick overview of insulin and the different types of diabetes so let’s start with insulin insulin as we know is really important it allows our bodies to use the sugar that we consume like glucose for energy and of course our bodies and our cells need energy to function more specifically insulin is a

Hormone that is naturally secreted into our blood by our pancreas the way that insulin works is it basically tells your body’s cells to open up and allow glucose to enter into them and once the glucose enters the cells the cells can use the glucose for energy production this is why you can think of insulin as a hormone that lowers blood glucose because again

It helps the body use up the glucose that is floating around in the bloodstream effectively lowering the blood glucose levels now people with diabetes either cannot produce enough insulin on their own or they have insulin resistance meaning their body cannot as easily use up the insulin that is available and without that insulin the glucose that is consumed when

Eating gets trapped in the bloodstream and cannot be used this leads to increased blood glucose levels which can have many negative effects on the body both short term and long term there are two main types of diabetes type 1 and type 2 which we won’t spend too long on in this video but here are the basics but you can definitely skip ahead if you’d like type 1

Diabetes typically occurs earlier in life and is characterized by very low to no insulin production by the pancreas type 1 diabetes is the rare reform with unknown causes but possibly linked to genetics most importantly type 1 diabetics are insulin dependent meaning they require external insulin to be injected as a replacement hormone and this will be required

For the rest of their lives type 2 diabetes typically occurs later in life and is characterized by a decrease in insulin production or an increase in insulin resistance both of which would lead to elevated blood glucose levels type 2 is more common and is often caused by poor diet and lifestyle type 2 diabetics typically do not require insulin injections type 2

Diabetes can often be managed by improving diet and lifestyle but may require pharmacological interventions such as oral anti-diabetic medications like metformin so to sum up the problem with diabetes is that the body is unable to use up the glucose due to the lack of insulin production from the pancreas this results in elevated blood glucose levels also known

As hyperglycemia now let’s get into how metformin works right off the bat it’s very important to note that metformin is not a type of insulin it is not an oral form of insulin or anything like that metformin helps to lower blood glucose in its own ways first metformin decreases hepatic glucose production which means that metformin decreases the production of

Glucose in the liver and by decreasing the production of glucose blood glucose will of course go down there will be less glucose overall metformin also helps to lower blood glucose by increasing the body’s sensitivity to insulin when the body is more sensitive to insulin it means that insulin has a greater effect it’s easier for the body to use the insulin so

Glucose can more easily be taken into the cells where it can be converted into energy so remember metformin is not insulin it helps to decrease blood glucose which is the same thing that insulin does but metformin works in its own way like we mentioned metformin is used in the management of type 2 diabetes that cannot be controlled by diet and lifestyle changes

Alone metformin most often comes as oral tablets of 500 milligrams 850 milligrams or 1000 milligrams a common dosage for metformin is to start at 500 milligram bid or twice a day and slowly increase the dose as needed anywhere between 2000 to 2550 milligrams per day is generally considered the maximum recommended dosage for metformin off-label metformin can be

Used for polycystic ovarian syndrome or picos metformin can cause a rare but serious condition known as lactic acidosis signs of lactic acidosis may include nausea and vomiting dizziness difficult or shallow breathing unusual muscle cramping or pain and more other general side effects may also include nausea and vomiting unpleasant metallic taste in the mouth

That usually goes away after a short period of time and hypoglycemia or abnormally low blood glucose levels hypoglycemia is not often caused by metformin due to it not having any direct influence on insulin secretion however it is still possible to occur especially if a patient does not eat enough or is taking other blood glucose lowering agents at the same time

Another important side effect to look out for is a decrease in vitamin b12 levels with metformin use metformin is thought to decrease vitamin b12 absorption contrast imaging procedures like ct scans may require iodinated contrast agents iodine contrast agents are contraindicated with metformin because they may increase the risk of lactic acidosis and impaired

Renal function oftentimes metformin will be held for 48 hours before and after the use of iodine contrast agents to reduce this risk type 2 diabetic patients may even be switched to temporary orders of insulin during this time period avoid metformin in patients with a history of lactic acidosis avoid use in metabolic acidosis renal or hepatic impairment high

Creatinine levels and more always remember to assess and monitor for side effects of metformin monitor blood glucose levels as needed and instruct patients to take metformin with meals for type 2 diabetics switching to insulin due to the administration of iodine contrast dye remind them that it is completely normal and that they can continue using metformin

After a couple of days pass and that’s about it for the basics of metformin if this video has helped you out please consider leaving a like and subscribe i would really appreciate it if you have any questions or would like me to review a specific drug or topic please let me know in the comments and thanks for watching

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Metformin (Fortamet/Glucophage) Nursing Drug Card (Simplified) – Pharmacology By Nurse Ryan