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Flashcards in Pharmacology: Metformin Deck (18)
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1

what type of compound is metformin

biguanide

2

what is the mechanism of metformin

inhibition of complex 1 of the mitochondrial respiratory chain(electron chain)

3

what is the main action of metformin

results in fall in cellular ATP(rise in ADP/ATP ratio)

4

what are some of the consequences of metformin

rise in AMP:ATP, activation of AMPK, reduction in gluconeogenesis

5

is metformin hydrophobic or philic

hydrophilic

6

how does meformin enter cells

requires active transport by Organic Cation Transporters(OCTs)

7

where are Organic Cation Transporters(OCTs) present in the body

intestines, liver, kidney

8

what is the main mechanism of metformin in the gut

increases glucose utilisation and metabolism

9

what is the main mechanism of metformin in the liver

lowers hepatic glucose production(in people with poorly controlled diabetes)

10

is metformin an insulin sensitiser

no, doesn't increase tissue sensitivity to insulin

11

does metformin affect weight

no

12

what is the clinical use of metformin in diabetes patients

lowers blood glucose levels

13

what is the usual dose of metformin

500mg bd
(max dose is 1g)

14

what are the side effects of metformin

GI intolerance(eg diarrhoea, pain, metallic taste in mouth), Metformin Associated Lactic Acidosis(MALA)

15

describe how GI intolerance effects those taking metformin and how to reduce this side effect

1 in 5 get this side effect, 1 in 20 need to stop due to this side effect
Initiate on lower dose slowly

16

how should metformin dose be changed in relation to renal function

metformin should be decreased as renal function falls

17

what effect can metformin have in those with acute kidney injury or sepsis

associated with increased risk of MALA(metformin associated lactic acidosis)

18

describe where metformin fits into diabetes treatment plan

first line therapy