treatment of type 2 diabetes mellitus
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Metformin
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Glucophage
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Type 2 diabetes mellitus
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Lactic acidosis (rare, but potentially fatal)
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Nausea, diarrhea, vomiting
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Unpleasant metallic taste
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Vitamin deficiencies (vitamin B12, folic acid)
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Monitor for indications of lactic acidosis.
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For signs of lactic acidosis, stop drug therapy immediately.
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Expect that severe lactic acidosis will require hemodialysis.
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Monitor for persistent nausea, vomiting, or diarrhea
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Monitor fluid intake and output.
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Monitor for indications of vitamin B12 or folic acid deficiency.
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Recommend the appropriate supplements.
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Monitor renal function upon initial therapy and yearly afterward
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Diarrhea, Dehydration
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Anemia
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Pituitary insufficiency
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Gastroparesis
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Gastrointestinal obstruction.
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Hyperthyroidism
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Older adults
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Give orally twice a day with the morning and evening meals (immedi- ate-release) or once a day with the evening meal (extended-release)
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Make sure clients swallow the extended-release form whole and do not crush or chew it.
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Avoid drinking alcohol.
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Report weakness, fatigue, lethargy, or hyperventilation.
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If these symptoms develop, stop taking the drug and seek medical care immediately
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Expect these effects to diminish as drug therapy continues
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Lie down when feeling nauseated
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Maintain adequate carbohydrate and fluid intak
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Report weakness, fatigue, pallor, or reddened tongue.
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Diabetic ketoacidosis
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Cardiopulmonary, hepatic, or renal insufficiency
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Alcoholism
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Heart failure
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Severe infection
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Shock
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Acute myocardial infarction
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Hypoxemia
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Lactic acidosis
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Alcohol and cimetidine (Tagamet) increase the risk of lactic acidosis.
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Any contrast medium containing iodine increases the risk of acute renal failure, thus worsening lactic acidosis
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Nifedipine (Procardia), furosemide (Lasix), morphine, antifungals, and many other drugs increase hypoglycemic effects.
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