DRUG NAME MECHANISM OF ACTION INDICATION / ADVERSE EFFECT NURSING RESPONSIBILITIES

CONTRAINDICATION

GENERIC: Decreases intestinal absorption of INDICATIONs: Endocrine: BEFORE:

METFORMIN HCL glucose and hepatic glucose Adjunct to diet to lower blood Hypogyny cemia, Dx:
BRAND: Diazen, Glucophage, production. It also improves insulin glucose with type2 (non lactic acidosis  Check Doctors order
Glucophage XR sensitivity (increase peripheral insulin-dependent) diabetes mellitus  Assess allergy to metformin
CLASS: hormone and synthetic glucose uptake and utilization). in patient. GI:  monitor bowel function
substitute; antidiabetic; biguanide Anorexia, nausea,  Check for allergies
THERAPEUTIC: Antidiabetic SOURCE: CONTRAINDICATION: vomiting,
PHARMACOLOGIC: Biguanide Contraindicated with e epigastric discomfort, heartburn, Tx:
DOSAGE: PPD’s Better Pharmacy Drug allergy to metformin; CHF; diarrhea,  Perform a thorough
Tablets 500,850,1,000 mg; ER hand book 9th Edition 2009 diabetes complicated by flatulence physical assessment to
tablets 500 mg fever, severe infections, establish baseline data
ROUTE: Oral severe trauma, major CNS: Headache, dizziness, before drug therapy begins,
surgery, ketosis, acidosis, agitation, fatigue. to determine the
coma(use insulin); type1 effectiveness of therapy,
(insulin-dependent),serious Hypersensitivity: and to evaluate for the
hepatic impairment, serious Al allergic skin reactions, occurrence of any adverse
renal impairment, uremia, eczema, pruritus, erythema, effects associated with drug
thyroid or endocrine urticaria therapy.
impairment, glycosuria,  Periodically assess dose.
hyperglycemia associated
with primary renal disease; EDx:
 Instruct patient that
DRUG TO DRUG
medication does not cure
INTERACTION:
diabetes
.
 Educate client on drug
therapy to promote
DRUG TO FOOD
compliance.
INTERACTION:
 Ensure the patient takes the
_________________
medication as prescribed.
DURING:
Dx:
 Monitor urine or blood for
glucose and ketones as
prescribed
 Monitor for adverse effects
(Nausea, vomiting,
anorexia, oral and gastric
irritation etc).
Tx:
 Administer the right dose at
the right time
 weight to monitor fluid
changes
 Provide safety measures
(e.g. adequate lighting,
raised side rails, etc.) to
prevent injuries
 Make sure patient has
swallow the medicine
EDx:
 instruct the patient to
swallow ER tablets whole;
do not cut, crush, or chew.
 advise to swallow the tablet
whole
AFTER:
Dx:
 Monitor cardiopulmonary
status throughout course of
therapy; cardiopulmonary
insufficiency may
predispose to lactic
acidosis.
 Document administration of
 drug
 monitor vital signs
especially cardiac changes
Tx:
 Arrange to monitor serum
electrolytes, hydration, liver
and renal function.
 Remember that a lot of
these drugs can cause
dizziness in the first few
weeks of taking so take
safety precautions.
 Provide safety measures
(e.g. adequate lighting,
raised side rails, etc.) to
prevent injuries.
 Provide comfort measures
(e.g. voiding before dosing,
taking food with drug, etc.)
to help patient tolerate drug
effects.
EDx:
 Instruct patient to notify
physician immediately of
signs of superinfection.
 Instruct pt. SO to report
diarrhea, nausea, dyspepsia,
insomnia, drowsiness,
dizziness, or persistent
headache to physician.
 Report diarrhea, nausea,
dyspepsia, insomnia,
drowsiness, dizziness, or
persistent headache to
physician.
 Instruct patient to verbalize
feelings and concerns.