Exam 2: Biguanides

Exam 2: Biguanides

1. Nursing Interventions

   • Monitor LFTs, BUN, and Cr before starting
     • Continue yearly monitoring

2. Pharmacokinetics

   • Not metabolized; excreted unchanged in urine

3. Adverse effects

   • Lactic acidosis
   • Metallic taste in the mouth
   • Dehydration
   • Decreased absorption of B12 and folic acid
   • Weight loss

4. Contraindications

   • Lactic Acid concern:
     • Alcoholism
     • Hepatic and renal impairment
     • Shock
     • Severe infection
     • Dehydration

5. Drug interactions

   • Can cause lactic acidosis
     • Contrast dyes
       • Stop taking 1-2 days before
       • Monitor BUN and Cr
     • Cimetidine
   • Hypoglycemics

6. Pharmacological action

   • Increases sensitivity of insulin receptions
   • Decreases absorption of glucose from the intestines
   • Decreases synthesis of glucose by the liver

7. Other information

   • Advantages
     • Safe for pregnancy
     • No weight gain
     • No hypoglycemia