UNIVERSITI TEKNOLOGI MARA CAWANGAN SELANGOR

KAMPUS PUNCAK ALAM

BACHELOR OF OCCUPATIONAL THERAPY (HONS)

HS245

FACULTY OF HEALTH SCIENCE

UPH654

Know Your Medicine

CASE STUDY

PREPARED FOR NUR SABIHA MD HUSSIN

PREPARED BY SITI RAS FATINAH BINTI MUHAMMAD IDRIS KUSHAIRI

STUDENT ID 2020884774

CLASS HS2454C
Description of the subject.

Name of the subject Mrs. SA

Age 57 years old
Height 150cm
Weight 94kg
Body Mass Index (BMI) 41.73 kg/m2 (Obese)

Past and current medication Past medication :

list. • Simvastatin 40mg Tablet
• Metformin HCI 500mg Tablet
• Gliclazide 30mg Tablet

Current medication :
• Simvastatin 40mg Tablet
• Metformin HCI 500mg Tablet
• Gliclazide 30mg Tablet
• Insulin Isophane (Insugen-N) 100 IU/mL P
• Montelukast Sodium 10mg Tablet – 28s
• Loratadine 10mg Tablet
• Budesonide 64mcg Nasal Spray -120 doses
Social history. • Married.
• Have 5 children.
• Housewife.
• Non-smoking, non-drug use and non-
alcoholic.
• Take 1 cup of caffeinated beverages each
morning.
• No recent travel history.
Past and current medical Past medical condition :
condition. • Type 2 Diabetes
Diabetes MellitusMellitus
Type 2
• Cholesterol
Current medical condition :
• Type 2 Diabetes
Diabetes MellitusMellitus
Type 2
• Cholesterol
• Sleep apnea
 Information about the Medication
1. Generic name of medicine Metformin Hydrochloride
2. Brand name of medicine Glumet DC
3. Specific indication of the Type 2 Diabetes Mellitus (MIMS Malaysia,
medicine n.d.)
4. Strength of the medicine Adult: 500mg, 850mg or 1,000mg
(DailyMed, 2019)
5. Dose of the medicine • 500mg
• 2 tablets 2 times daily.
6. Instruction on how to take • Should be taken with food.
medicine • Swallow the medication.
• Do not chew or crush the medication.
• Do not stop taking the medication
without doctor’s advice.
7. Formulation of the medicine Metformin HCl 500mg tablets were
prepared by wet granulation method
according to the formulation given in Table
1. (Rashid et. al., 2013)
Ingredients Quantity/tablet
(mg)
Metformin HCl 500
PVP K30 15
Avicel PH 102 93
Sodium stach 8
glycolate
Magnesium 10
stearate
Talcum 2
Cab-O-Sil 2
Isopropyl alcohol Q.S.
Total weight of 630
tablet
8. Route of administration
9. Registration number
10. Medicine storage
11. Contraindications
12. Adverse reactions
• Oral
• MAL06081220AZ
• Out of reach of children
• Store below 30°C.
• Protect from light and moisture.
• Acute or chronic metabolic acidosis
with or without coma
• Acute conditions which alter renal
function such as dehydration, severe
infection or shock.
• Acute or chronic disease-causing
hypoxia such as unstable cardiac or
respiratory failure, recent myocardial
infarction or shock
• Acute alcohol intoxication or
alcoholism
• Severe renal impairment (eGFR<30
mL/min)
• Intravascular administration of
iodinated contrast agents. (MIMS
Malaysia, n.d.)
1. Significant for Vitamin B12 deficiency
2. Cardiac disorders:
− Chest discomfort, palpitations,
dyspnoea.
3. Gastrointestinal disorders:
− Nausea, vomiting, diarrhoea,
abdominal pain, flatulence,
heartburn/dyspepsia, abdominal
distention, abnormal stools,
constipation.
4. General disorders and admin site
conditions:
 − Asthenia, flu-like symptoms, malaise.
5. Hepatobiliary disorders:
− Cholestatic, hepatocellular, mixed
hepatocellular liver injury.
6. Musculoskeletal and connective
tissue disorders:
− Myalgia, chills.
7. Nervous system disorders:
− Taste disturbance, headache.
8. Psychiatric disorders:
− Increased somnolence.
9. Respiratory, thoracic and mediastinal
disorders:
− Upper respiratory tract infection.
10. Skin and subcutaneous tissue
disorders:
− Nail disease, rash.
11. Vascular disorders:
− Flushing. (MIMS Malaysia, n.d.)
13. Use in pregnancy and lactation • FDA pregnancy category B which is
either animal-reproduction studies
have not demonstrated a foetal risk
but there are no controlled studies in
pregnant women or animal-
reproduction studies have shown an
adverse effect (other than a
decrease in fertility) that was not
confirmed in controlled studies in
women in the 1st trimester (and
there is no evidence of a risk in later
trimesters) (Balsells et. al., 2015)
• A study do not suggest that
metformin use in pregnancy can
 cause congenital anomaly but
confidence intervals remain wide
because of small sample size.
(Lindsay & Loeken, 2017)
• Need special precaution for the
consumer during pregnancy and
lactation. (MIMS Malaysia, n.d.)
• There is no evidence in increased
risk of congenital anomalies
combined after exposure to
metformin during the first trimester of
pregnancy. (Given et. al., 2018)
14. Shape of medicine Round and biconvex
15. Colour of medicine White to off-white coloured
16. Photo of the medicine
REFERENCE
DailyMed. (2019). METFORMIN HYDROCHLORIDE- metformin hydrochloride
tablet. Dailymed.nlm.nih.gov. Retrieved from
https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=98c4b9a5-b8da-4bf0-
bd52-7fc79152e414.
MIMS Malaysia. Metformin: Indication, Dosage, Side Effect, Precaution | MIMS
Malaysia. Mims.com. Retrieved from
https://www.mims.com/malaysia/drug/info/metformin?mtype=generic.
Rashid, N. S., Muhammad, A., Abdul, M., Muhammad, N., Hassali, K. A., & Azmi, M.
(2013). Formulation development of metformin tablet and its comparative in-
vitro study with different brands in Pakistan. International Journal of
Pharmaceutical Sciences Review and Research, 19, 12-17.
Balsells, M., García-Patterson, A., Solà, I., Roqué, M., Gich, I., & Corcoy, R. (2015).
Glibenclamide, metformin, and insulin for the treatment of gestational
diabetes: a systematic review and meta-analysis. Bmj, 350.
Lindsay, R. S., & Loeken, M. R. (2017). Metformin use in pregnancy: promises and
uncertainties. Diabetologia, 60(9), 1612-1619.
Given, J. E., Loane, M., Garne, E., Addor, M. C., Bakker, M., Bertaut-Nativel, B., ... &
Dolk, H. (2018). Metformin exposure in first trimester of pregnancy and risk of
all or specific congenital anomalies: exploratory case-control study. bmj, 361.