To elaborate a procedure to control patients in treatment with metformin to whom contrast iodized is injected endovascular via,
and to avoid possible adverse reactions,
especially lactic acidosis.
Methods and Materials
Mechanism of action of metformin: Metformin is a biguanide drug widely used to control hyperglycemia in type 2 diabetes melitus. The proposed mechanism of action of metformin is: to reduce liver gluconeogenesis enhancing peripheral glucose production uptake,
as a result of increased sensitivity of peripheral tissues to insulin. Metformin is excreted unchanged by the kidneys.
The renal route eliminates 90% of the absorbed drug within the first 24 hours.
Metformin seems to cause increased...
Most of the patients are elderly,
but there are also young patients (outliers on the left),
so that the age curve does not follow a normal distribution.
The mean age of patients was 69 years ( Table 1 ). In tables in sex distribution,
there is a significant difference,
with more men in the study ( Table 2 ).
In 92% of the cases studied the interval between administration of IV contrast and test performance of renal function was maximum 72h ( Table 3 ). Ultimately there are not significant...
The implementation of this procedure allowed control all of the patients in treatment with metformin to whom contrast iodized is injected endovascular via. To restart metformin administration has been surveyed by primary care physician.
This procedure is protocolized for not overworking primary care doctor. Acording this,
we could avoid complications from uncontrolled reintroduction of the drug (metformin).
Canadian Association of Radiologists: Guidelines for the Prevention of Contrast Induced Nephropaty.
Published 2007. Systematic review of current guidelines,
and their evidence base,
on risk of lactic acidosis after administration of contrast medium for patients receiving metformin.
Radiology 2010; 254:261-9. Royal Australian and New Zealand College of Radiologists.
Guidelines for Metformin Hydrochloride and Intravascular Contrast Media....