Clinical Medications Worksheets

Generic Name Trade Name Classification Dose Route Time/frequency

metformin Glugophage Oral Antidiabetic 500mg PO BID with meals
biguanides
Peak Onset Duration Normal dosage range
2-4 weeks Several days 12 hrs 500 mg twice daily; may increase by 500 mg at weekly intervals up to
2000 mg/day.

Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions
Type II Diabetes N/A

Mechanism of action and indications Nursing Implications (what to focus on)

(Why med ordered)
Decreases hepatic glucose production, Decreases intestinal
glucose absorption, and Increases sensitivity to insulin.
Indicated for the management of type 2 diabetes mellitus; may
be used with diet, insulin, or sulfonylurea oral hypoglycemic
Management of blood glucose
Contraindications/warnings/interactions
.;Hypersensitivity, metabolic acidosis, dehydration, sepsis, hypoxia,
hepatic impairment, excessive alcohol use, Renal dysfunction,
Radiographic studies requiring iv iodinated contrast media, CHF. Use
cautiously in geriatric/debilitated patients (↓ doses may be required;
avoid in patients >80 yr unless renal function is normal). Interacts with
other drugs include Acute or chronic alcohol ingestion or iodinated
contrast media ↑ risk of lactic acidosis, amiloride , digoxin , morphine ,
procainamide , quinidine , ranitidine , triamterene , trimethoprim ,
calcium channel blockers , and vancomycin may compete for elimination
pathways with metformin. Altered responses may occur, cimetidine and
furosemide may ↑ effects of metformin. Natural interactions include
glucosamine may worsen blood glucose control and Chromium , an

Common side effects

Diarrhea, nausea, vomiting, abdominal bloating

Interactions with other patient drugs, OTC or herbal
medicines (ask patient specifically)
Furosemide may increase the effects of metformin
Lab value alterations caused by medicine
May cause false-positive results for urine ketones
Be sure to teach the patient the following about this
medication
Instruct patient to take metformin at the same time each day, as directed.
If a dose is missed, take as soon as possible unless almost time for next
dose. Do not double doses. Explain to patient that metformin helps
control hyperglycemia but does not cure diabetes. Therapy is usually long
term. Encourage patient to follow prescribed diet, medication, and
exercise regimen to prevent hyperglycemic or hypoglycemic episodes.
Review signs of hypoglycemia and hyperglycemia with patient. If
hypoglycemia occurs, advise patient to take a glass of orange juice or 2-3
tsp of sugar, honey, or corn syrup dissolved in water, and notify health
care professional. Emphasize the importance of routine follow-up exams
and regular testing of blood glucose, glycosylated hemoglobin, renal
function, and hematologic parameters.
Nursing Process- Assessment
(Pre-administration
assessment)
fingerstick blood glucose
Assessment
Why would you hold or not give
this med?
If fsbg is less than 100, before or at the
time of studies requiring IV
administration of iodinated contrast
media and for 48 hr after study
Evaluation
Check after giving
Control of blood glucose levels without the appearance
of hypoglycemic or hyperglycemic episodes. Control
may be achieved within a few days, but full effect of
therapy may be delayed for up to 2 wk. If patient has
not responded to metformin after 4 wk of maximum
dose therapy, an oral sulfonylurea may be added. If
satisfactory results are not obtained with 1-3 months of
concurrent therapy, oral agents may be discontinued
and insulin therapy instituted