CLINICAL QUERIES: Why hold the metformin?
Joan E. King RN,C, ACNP, ANP, PhD

$3.95
Nursing2014
July 2004 
Volume 34  Number 7
Pages 20 - 20
 
  PDF Version Available!

ABSTRACT
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    My patient, 72, takes metformin (Glucophage) and glimepiride (Amaryl) to control his Type 2 diabetes. He was scheduled for an arteriogram of an abdominal aortic aneurysm, but it was canceled because he'd taken his morning dose of metformin. Why would this scuttle the test? —K.D., S.C.

    Joan E. King, RN,C, ACNP, ANP, PhD, replies: Patients with diabetes who receive an I.V. iodinated contrast medium may experience acute renal failure. Because metformin is excreted by the kidneys, it may accumulate if renal problems develop. This could lead to potentially fatal lactic acidosis.

    Because of his age and diabetes, your patient probably has renal insufficiency already. His abdominal aortic aneurysm also may impair renal function, increasing his vulnerability.

    To reduce the risk of nephrotoxicity, the health care provider could use low- or iso-osmolar contrast media. Or she could order an alternative imaging ...

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