February 1, 2023

Metformin is an anti diabetic medication, belonging to the biguanide class of drugs. It is the first line treatment option for people with type two diabetes mellitus. Its major mechanism of action is to reduce hepatic gluconeogenesis by increasing the activity of an enzyme called Adenosine mono phosphate activated protein kinase, or AMPK for short. Following administration, metformin inhibits the mitochondrial respiratory chain complex in the cells, leading to decreased ATP levels, which is the main stimulus for activating AMPK.

Metformin is an anti-diabetic medication belonging to the biguanide class of drugs it is the first line treatment option for people with type 2 diabetes mellitus its major mechanism of action is to reduce hepatic gluconeogene by increasing the activity of an enzyme called adenosine monophosphate activated protein kinase or ampk for short following administration

Metformin inhibits the mitochondrial respiratory chain complex in the cells leading to decreased atp levels which is the main stimulus for activating ampk ampk is a key regulator of energy homeostasis within the cells activation of this enzyme increases the overall cellular catabolism and reduces anabolism it reduces hepatic gluconeogenesis by inhibiting the genes

Responsible for the synthesis of pep carboxy kinase and glucose 6-phosphatus which are key enzymes in the gluconeogenesis pathway it also increases the glucose uptake in the peripheral tissues by inducing translocation of glut4 into the cell membrane in addition ampk increases fatty acid oxidation decreases glycogen protein fatty acid and cholesterol synthesis

Decreases intestinal absorption of glucose and reduces ldl cholesterol levels while increasing hdl cholesterol this reduces the cardiovascular disease risk in type 2 diabetic patients most of the time treatment of type 2 diabetes is started with metformin alone however if the patient is not responding well to monotherapy metformin can be given in combination with

Other oral hypoglycemics or insulin it is available in immediate and slow release formulations and is also indicated for the treatment of polycystic ovarian syndrome and gestational diabetes considering pharmacokinetics of the drug metformin has a 50 to 60 oral bioavailability and has a very low plasma protein binding duration of action is around six to eight hours

Metformin is not metabolized by the liver therefore it is excreted unchanged in urine by tubular secretion for this reason metformin is contraindicated in renal failure finally let’s see some common adverse effects of metformin this medication is usually well tolerated by most individuals weight loss is the most common adverse effect gastrointestinal disturbances

Such as abdominal discomfort nausea and vomiting and diarrhea may occur in some individuals in addition anorexia and metallic taste are some other adverse effects hypoglycemia does not occur with metformin lactic acidosis is a rare but serious adverse effect of metformin especially in patients with hepatic and renal failure lactic acid is a product of anaerobic

Respiration of the cells usually this lactic acid is taken up by the liver and utilized in the process of gluconeogenesis however as metformin inhibits gluconeogenesis excess lactic acid is mainly excreted by the kidneys if an individual with renal impairment takes metformin lactic acid tends to accumulate in blood causing serious complications therefore metformin

Is contraindicated in patients with liver disease and renal failure

Transcribed from video
Metformin – Uses, Mechanism Of Action, Adverse Effects & Contraindications By Med TodayliveBroadcastDetails{isLiveNowfalsestartTimestamp2022-06-19T023018+0000endTimestamp2022-06-19T023546+0000}