Metformina

Question 1

Effetti avversi

Answer 1

Metformin-associated lactic acidosis

Gastrointestinalprodromalsymptoms: nausea, vomiting,diarrhea, abdominalpain

Severe symptoms: muscle cramps,hyperventilation,apathy,disorientation,coma

Elderly individuals :Patients with cardiac or renal insufficiency

Diagnostics

Arterial blood gas(ABG):metabolic acidosisandanion gap

↑ Serumlactate

Treatment: discontinuemetforminand treatacidosis

Gastrointestinal complaints are common: nausea,diarrhea, flatulence

Vitamin B12 deficiency

Metallic taste in the mouth (dysgeusia)

Question 2

Controindicazioni

Answer 2

Renal failure(ifcreatinine clearance< 30 mL/min)

Severeliverfailure

Intravenousiodinated contrast medium

Pausemetforminprior to surgery

Chronic pancreatitis, starvationketosis,ketoacidosis,sepsis

Heart failure(NYHAIII and IV), respiratory failure,shock,sepsis

Alcoholism

Important interactions:sulfonylureas

Metformintreatment must be paused prior to the administration of a contrast medium or scheduled surgery to reduce the risk oflactic acidosis!!!