A patient taking metformin develops severe vomiting and diarrhoea with poor oral intake. Which instruction is most appropriate?
Correct answer: A. Contact the prescriber about temporarily withholding metformin
- A. Contact the prescriber about temporarily withholding metformin
- B. Take an extra dose to prevent stress-related hyperglycaemia
- C. Continue the medicine and restrict all oral fluids
- D. Replace metformin with a bedtime dose of insulin without advice
Explanation
Dehydration and acute illness can increase the risk of metformin-associated lactic acidosis, so the patient should seek advice about temporarily withholding it. The patient also needs assessment and adequate fluid replacement as clinically appropriate.
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About Endocrine and Diabetes Drugs
Endocrine pharmacology includes insulin preparations, oral antidiabetic drugs, thyroid and antithyroid medicines, corticosteroids, sex hormones and drugs affecting calcium balance. Questions address onset and duration, administration, monitoring, hypoglycaemia, steroid adverse effects and the difference between replacing a deficient hormone and suppressing excessive hormone activity.
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