which of the following is a contraindication for metformin therapy? course hero

The authors identified the following potential contraindications or cautions to metformin therapy: (1) renal impairment, defined as a plasma creatinine level greater than 1.4 mg per dL (120 μmol per L) or dipstick-positive proteinuria, (2) cardiac failure, (3) chronic hepatic dysfunction, (4) significant chronic pulmonary disease, (5) coronary artery disease, (6) peripheral vascular disease, and (7) miscellaneous conditions (intercurrent illnesses, acute trauma or major surgical procedures, and metastatic malignancy).

Full Answer

What are the contraindications for metformin?

This at least avoids non-specific and unhelpful terms such as renal insufficiency or renal impairment. If adherence to the published contraindications, all of which relate to the feared risk of lactic acidosis, were to be strict, metformin would, or rather should, be seldom prescribed at all.

What are the guidelines for the use of metformin in type 2 diabetes?

A simplified and pragmatic set of guidelines should be adopted, stressing the importance of renal clearance of metformin and withdrawal of metformin in patients with tissue hypoxia. As metformin is the only oral hypoglycaemic agent proved to reduce cardiovascular mortality, its use should be as widespread as possible in type 2 diabetes.

Does metformin reduce cardiovascular events?

According to the United Kingdom prospective diabetes study, patients with type 2 diabetes randomised to intensive treatment with metformin, sulphonylurea, or insulin had similar degrees of glycaemic control and significantly reduced microvascular end points. The study showed that the use of metformin in obese patients reduced cardiovascular events.

What is metformin used for?

Metformin is proved to reduce plasma glucose and complications of diabetes. Uniquely, it is the only hypoglycaemic agent to date that has been shown to reduce the macrovascular complications of diabetes. Current published guidelines vary and may limit the use of metformin and cause confusion among doctors.

How long after iodine is given to withdraw from metformin?

Withdraw during periods of suspected tissue hypoxia (for example, due to myocardial infarction, sepsis). Withdraw for three days after contrast medium containing iodine has been given, and start treatment with metformin only after renal function has been checked.

Is metformin a rare condition?

Lactic acidosis associated with metformin is a rare condition with an estimated prevalence of one to five cases per 100 000. 2Although classically lactic acidosis associated with metformin has been thought of as lactic acidosis secondary to accumulation of metformin, the evidence for this is poor.

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18.Which of the following are potential side effects of NSAIDs in older adults?19.Why is Metformin not the best antidiabetic agent for an older adult with renal insufficiency?a.It may cause auditory nerve damage.b.It causes oversedation in patients.c.It is cleared through the kidneys.d.It inhibits liver enzymes from breaking down other medications.ANS: CFeedbackAAuditory nerve damage is associated with aminoglycosides and loop diuretics.BMetformin is not known to cause sedation.CCorrect!DMetformin does not inhibit hepatic enzymes.PTS:120.There are several oral antidiabetic agents available for use in older adults.

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