Mode Of Action
Patient Teaching
• Instruct patient to
inform a provider
immediately if any
hypersensitivity
reaction occurs
• Caution patient to
avoid alcohol
• Metformin is not
indicated for
patients with an
eGFR below 30
mL/min
• Monitor patient
closely for signs of
lactic acidosis that
often are subtle and
nonspecific such as
GI effects and
respiratory distress
• Most cases of lactic
acidosis occur in
patients at high risk,
do not take if you
are at high risk or
have renal
impairment
• (Jones &
Bartlett,2021)
Metformin
Adverse Effects
•
•
•
•
•
•
•
Hypoglycemia
Hepatic injury
Aplastic or
hemolytic anemia
Aplastic anemia
Thrombocytopenia
Lactic Acidosis
(Jones & Bartlett,
2021)
Non- Insulin Medication
for diabetes
Therapeutic Use
• Indicated for those
with type 2 diabetes
mellitus
• (Burchum &
Rosenthal,2019)
May promote storage of excess glucose as
glycogen in the liver, which reduces
glucose production. Metformin may also
increase the number of insulin receptors.
(Jones & Bartlett,2021)
Expected Therapeutic Effect
• Reduce blood glucose levels in
patients with type 2 diabetes
mellitus.
• (Burchum & Rosenthal,2019)
Evaluation
Contraindications
Evaluate the patients blood glucose
levels to evaluate the effectiveness of
the drug. (Burchum & Rosenthal,2019)
Hypersensitivity,
calcium channel
blockers, cationic drugs,
hyperglycemia, renal
impairment (Burchum &
Rosenthal,2019)
Elderly and those at increased risk should be
assessed for eGFR more frequently. Those with
an eGFR between 45 and 60 ml/min should not
be taking metformin.
(Jones & Bartlett, 2021)
Jonathan Roberts
Inform clients of the importance of a good diet,
exercise and to constantly check their blood
glucose levels. Teach the patient how to
distinguish between hyperglycemia and
hypoglycemia. Withhold drug as ordered if the
patient becomes hypoxemia or sepsis because
these conditions increase the risk of lactic
acidosis.
(Jones & Bartlett, 2021)
Patient Teaching
• Take medication with
food in the morning if
taken once a day or in
the morning with
breakfast and at night
with dinner to reduce GI
effects.
• Take ER tablets at night
with dinner
• Avoid alcohol
• Inform patient to get
their glomerular
filtration rate at least
annually
• (Jones & Bartlett,2021)
References
Jones & Bartlett Learning, LLC. (2021). 2021 Nurse's Drug Handbook.
Burchum, J. R. & Rosenthal, L. D. (2018). Lehne's pharmacology for nursing care (10th ed.). Saunders.