UNIVERSITI TEKNOLOGI MARA (UiTM)
PUNCAK ALAM CAMPUS
FACULTY OF HEALTH SCIENCES
BACHELOR OF PHYSIOTHERAPY (Hons.)
HS244
UPH654 KNOW YOUR MEDICINE
CASE STUDY 20%
PREPARED BY:
SITI NUR ERINA BT AHMAD
2020828854
HS2444E
PREPARED FOR:
PN. NUR SABIHA BINTI MD HUSSIN
SUBMISSION DATE:
21st MAY 2021
Metformin
Miss S is a 53-year-old Malay woman with endomorph body size. Her weight is 70 kg with height
156 cm and the current BMI is 28.76 which considered as overweight. Her past medication is
metformin, simvastatin, perindopril, amlodipine, calcitriol, calcium carbonate and baclofen. Her
current medication is same as the past medication since she still consumes the medications. Miss
S works as a primary school’s teacher. Her nature of work is prolonged standing, climbing stairs,
and writing. She lives with her husband and three children. Miss S’s hobby is gardening and
cooking. For past medical condition, Miss S has alleged in MVA (car vs oil palm tree) in 2006 and
had undergo surgery to remove glass embedded in forehead. Other than that, she also has
hypertension (HPT), diabetes mellitus (DM) and osteoarthritis in the last five years. Miss S current
medical condition is hypertension, diabetes mellitus and osteoarthritis and there is no newly
diagnosed condition.
Medicine
Generic name Metformin
Brand name Glucoxit
Specific indication Type 2 diabetes mellitus
Strength of medicine 500mg
Dose • Adult: 500 mg thrice daily, can be take
up to 3 gm if necessary.
• Pediatric: the efficacy and safety of
metformin therapy have not been
established yet.
• Geriatrics: use the same dose as adults
but lower dose is required for sensitive
individuals.
• Pregnancy: 500-2500 mg/day
• Renal impairments:
GFR mL/min Total maximum of
daily dose (divided
into 2-3 daily
doses)
60-89 3000 mg
45-59 2000 mg
30-44 1000 mg
<30 None (metformin
is contraindicated)
Medicine intake instruction • Take ½ tablet, twice per day
• Take after eating food
• Do not chew or crush the tablet
• Do not stop this medication intake
without consulting the doctor
Formulation of the medicine Chemical formula: C4H11N5
Chemical structure:
Route of administration Oral
Registration number MAL19870410AZ
Medicine storage Store in a dry place below 30o, away from the
light and keep it at place that cannot be reach
by children.
Contraindications • Severely decreased kidney function
(GFR <30 mL/min)
• Acute metabolic acidosis such as lactic
acidosis and diabetic ketoacidosis
• Patients with hypersensitivity to
metformin
• Cardiac failure
• Chronic kidney disease (CKD)
• Hepatic failure and cirrhosis
• Respiratory insufficiency
Adverse reactions • Anorexia
• Dyspepsia
• Flatulence
• Headache
• Nausea
• Lactic acidosis (might be present in
patient that is contraindicated to this
metformin therapy)
Use in pregnancy and lactation Pregnancy:
• Metformin intake during pregnancy is
safe and effective for patients with
gestational diabetes mellitus (GDM) as
it has been proven to lower the risk of
pregnancy induced hypertension
(PIH), neonatal hypoglycemia and less
maternal weight gain.
• But caution is needed as it has the
potential to cause fetal malformations,
risk of stillbirth and macrosomia
especially if the intake is
uncontrollable.
Lactation:
• Despite the fact that metformin is
excreted in human breastmilk, no
adverse effects have been recorded in
breastfed neonates. However, it is
recommended to stop breastfeeding
while taking metformin to avoid any
potential danger of ill effects on the
baby.
Shape of medicine Round, bi-convex tablet
Color of medicine White
Photo of medicine:
REFERENCES
Adriana Stoica, R., Simona Ștefan, D., Rizzo, M., Iulia Suceveanu, A., Paul Suceveanu, A.,
Serafinceanu, C., & Pantea-Stoian, A. (2020). Metformin indications, dosage, adverse reactions,
and contraindications. Metformin. https://doi.org/10.5772/intechopen.88675
Ghosal, S. (2019). The side effects of metformin - A review. Diabetes & Metabolic Disorders, 6(1), 1-
7. https://doi.org/10.24966/dmd-201x/100030
Glucophage dosage/Direction for use. (n.d.). Search Drug Information, Interactions, Images, Dosage &
Side Effects | MIMS. https://www.mims.com/malaysia/drug/info/glucophage/dosage
Metformin. (n.d.). https://go.drugbank.com/drugs/DB00331
(Metformin 500mg.spesific product characteristic.2020)
Nguyen, L., Chan, S., & Teo, A. K. (2018). Metformin from mother to unborn child – Are there
unwarranted effects? EBioMedicine, 35, 394-
404. https://doi.org/10.1016/j.ebiom.2018.08.047
Priya, G., & Kalra, S. (2018). Metformin in the management of diabetes during pregnancy and
lactation. Drugs in Context, 7, 1-21. https://doi.org/10.7573/dic.212523
Sanchez-Rangel, E., & Inzucchi, S. E. (2017). Metformin: Clinical use in type 2
diabetes. Diabetologia, 60(9), 1586-1593. https://doi.org/10.1007/s00125-017-4336-x
