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yosra ashraf

on 23 April 2015

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Transcript of Metformin

Diabetes insipidus

Neurological form,
called Central DI (CDI), which involves a deficiency in antidiuretic hormone (ADH).

Type I (IDDM)
Characterized by loss of the insulin-producing beta cells of the islets of Langerhans in the pancreas.
Less insulin +insulin resistance = a condition in which cells fail to respond to insulin properly
Gestational Diabetes
Occurs when pregnant women without a previous history of diabetes develop a high blood
glucose level.
Diabetic ketoacidosis (DKA)
hyperosmolar hyperglycaemic state (HHS).
Oral Antidiabetic
Insulin senstizier
First line drug of choice for the
treatment of (Type 2 diabetes)

Chemical Name
Carbamimidamido-N-N dimethylethanimdamide
Trade Names
Uses & Indication
1-Antihyperglycemic agent in NIDDM.
2- Decreases fasting plasma glucose level and has +ve effect on lipids level.
3-Weight loss for diabetic and non-diabetic patients.
Metformin has
absolute oral absorption of 40 to 60% and gastrointestinal absorption is complete within 6 hours of ingestion"

Distribution :
1- Rapidly distributed followed by absorption.
2-Doesn't bind to plasma protein ,so
No metabolites or conjugates of metformin.
renal excretion
& has
a mean plasma elimination half life after oral administration of between
4 to 8 hours
and is
in patient with
renal impairment
New Uses
Protect from cancer as it has tumor suppression ability where it reduces the neoplasiain multiple cancer types
Inhibition of protein synthesis
Induction of cell cycle arrest or apoptosis
Activation of immune system
Side effects
Common side effects
Less common side effects
Anxiety , Coma , Chest pain ,Blurred vision ,Depression , pale skin
Rare :
-Behavior change similar to be drunk
-Difficulty with concentration , drowsiness
-Lack or loss of strength ,restless sleep
A group of metabolic diseases in which there are high blood sugar levels over a prolonged period.
Types of Diabetes
It is characterized by polydipsia, polyuria, and severly diluted urine & upon reduction of fluid intake, no effect on the concentration of the urine.

Nephrogenic diabetes insipidus(NDI),
which is due to kidney or nephron dysfunction caused by an insensitivity of the kidneys or nephrons to ADH.

Types of Diabetes insipidus
Lactic Acidosis !!!
It is rare but serious metabolic complication occur due to accumulation of metformin.
Characterized by elevated blood lactate levels (>5 mmol/L), decreased blood pH, electrolyte disturbances with an increased lactate/pyruvate ratio
Drug Interactions of Metformin
ؤCalcium Channel Blockers
• if you have vomiting, diarrhea, poor health or nutrition, low blood calcium or vitamin B12levels, or anemia.

• if you have an infection, fever, recent injury, or moderate to severe burns

Dose and
dose regimen

No fixed dosage regimen
Dosage of Metformin tablets must be individualized on the basis of both effectiveness and tolerance.
Metformin hydrochloride tablets should be given in divided doses with meals.

Metformin hydrochloride extended-release tablets should generally be given once daily with the evening meal.

Should be started at a low dose, with gradual dose escalation.
• To reduce gastrointestinal side effects
• To permit identification of the minimum dose required for adequate glycemic control of the patient.

Pharmacological class
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