Generic name: Metformin

Brand Names: Glucophage, Fortamet

An oral diabetes medicine that helps control blood sugar. Metformin are used to treat type 2 diabetes.

·         Diarrhea

·         Decreased appetite

·         Painful or difficult urination 

·         Hypoglycemia

·         Fever or chills

·         Fast or shallow breathing

·         Stomach bloating

·         General feeling of discomfort

·      Sleepiness

·         Muscle pain or cramping

·         Lower back or side pain

2.      Inform the doctor to alter dosage if patient has a condition that decreases or delays gastric emptying, such as diarrhea and gastroparesis.

3.      Monitor patient’s blood glucose level to evaluate drug effectiveness and glycemic control.

4.      Assess for contraindications or cautions (e.g: allergy to drugs, severe renal and hepatic dysfunction, etc.) which are contraindications in the use of these agents.

5.      Advice patient to eat small meals several times a day to avoid increase of gas build up which cause bloating.

 

Lower insulin resistance in muscle, fat and reduce glucose produced in liver resulting in glycemic control without hypoglycaemia

Thiazolidinediones 

·         which known as glitazones

·         Example of medication: Pioglitazone (Actos), Rosiglitazone (Avandia), Lobeglitazone (Duvie)

·         Uses: decreased blood glucose levels and preservation of the pancreas’s ability to produce sufficient levels of insulin. To help lower blood pressure and improve lipid metabolism by increasing levels of HDL and reducing levels of triglycerides

·         Side effects: water retention, weight gain, eyesight problems, reduced sense of touch, chest pain, infections and allergic skin reaction

·         Less common but dangerous side effects: macular oedema, heart problems, liver failure, anaemia and bone fracture

·         Nursing responsibilities: 

1.       observe patient for any signs and symptoms of hypoglycemic reactions (sweating, hunger, weakness, dizziness, tremor, tachycardia and anxiety)

2.       monitor fluid retention, especially in patient with history of heart disease

3.       monitor patient’s LDL and triglycerides for elevation

4.       monitor liver function

5.       arrange dietary teaching for weight control and encourage patient to follow

6.       instruct patient to have serum alanine aminotransferase (ALT) checked 6 months after baseline

7.       advice women of childbearing age to use backup contraception because these medications reduce blood levels of some PO contraceptive

 

                      Biguanides 

·         Example of medication: Metformin ( the only biguanide is classified as an insulin sensitizer)

·         Uses: it increase glucose uptake and use by target tissues thereby decreasing insulin resistance

·         Side effects: heartburn, stomach pain, nausea, vomiting, bloating, diarrhea, weight loss and headache

·         Dangerous side effects: lactic acidosis

·         Nursing responsibilities: 

1.       Monitor GI tract effects such as anorexia, nausea and vomiting

2.       Monitor for lactic acidosis especially patient with renal failure or liver dysfunction

3.       Monitor for renal function of the patient

4.       Advice patient to take vitamin B12 and folic acid supplement to avoid vitamin B12 and folic acid deficiency  

5.       Ask patient to take metformin with meals to avoid GI problems

 

Group 4:

·         Aquiline Anak Nancy (55260)

·         Farhanis Bt Muhammad Yusoff (55944)

·         Goh Jin Wang (56049)

·         Nur Syamilah Dahban (57366)

·         Venissa Vienna Anak Sengga (58220)