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Pioglitazone/metformin should not be used in people with type 1 diabetes or for the treatment of diabetic ketoacidosis and should be used with caution in people with edema. Serum ALT levels should be evaluated prior to the initiation of therapy with combination of pioglitazone and metformin and periodically thereafter per the clinical judgment ...
Metformin has acid dissociation constant values (pK a) of 2.8 and 11.5, so it exists very largely as the hydrophilic cationic species at physiological pH values. The metformin pK a values make it a stronger base than most other basic medications with less than 0.01% nonionized in blood.
The term "biguanidine" often refers specifically to a class of drugs that function as oral antihyperglycemic drugs used for diabetes mellitus or prediabetes treatment. [4] Examples include: Metformin - widely used in treatment of diabetes mellitus type 2; Phenformin - withdrawn from the market in most countries due to toxic effects
The pH of a solution of a monoprotic weak acid can be expressed in terms of the extent of dissociation. After rearranging the expression defining the acid dissociation constant, and putting pH = −log 10 [H +], one obtains pH = pK a – log ( [AH]/[A −] ) This is a form of the Henderson-Hasselbalch equation. It can be deduced from this ...
Buffer capacity falls to 33% of the maximum value at pH = pK a ± 1, to 10% at pH = pK a ± 1.5 and to 1% at pH = pK a ± 2. For this reason the most useful range is approximately pK a ± 1. When choosing a buffer for use at a specific pH, it should have a pK a value as close as possible to that pH. [2]
A 2004 statement by the European Society for Paediatric Endocrinology and the Lawson Wilkins Pediatric Endocrine Society (for children) uses slightly different cutoffs, where mild DKA is defined by pH 7.20–7.30 (bicarbonate 10–15 mmol/L), moderate DKA by pH 7.1–7.2 (bicarbonate 5–10) and severe DKA by pH<7.1 (bicarbonate below 5).
[1] [10] Acanthamoeba keratitis is a rare disease primarily affecting contact lens wearers. [1] The applicant for this medicinal product is SIFI SPA. [1] Polihexanide was approved for medical use in the European Union in August 2024. [1] [2]
Metformin (Glucophage) is considered a better drug for these patients. Sulfonylureas should be used with caution or generally avoided in patients with hepatic and renal impairment, patients with porphyria , patients who are breastfeeding , patients with ketoacidosis , and elderly patients.