The Drug Investigations - Three So Far

allnurses Guide · Dec 21, 2019

3 minutes ago, myoglobin said:
I have several thoughts on this subject mostly related to metformin:
1. Most studies including RCT's have shown that metormin actually reduces dementia risk in diabetic individuals. For example this metaanalysis which looked at over ten studies (including two RCT's) came to this conclusionhttps://www.ncbi.nlm.nih.gov/pubmed/30149446 .
2. Metformin is one of the few chemical shown to actually extend lifespans of animals (although because of our relatively long lifespans data is not available in humans). Other than caloric restriction (with adequate nutrition) there is probably no more reliable way to extend the lifespan of an organism than with Metformin.
3. Having said that the best way to treat most cases of Type II diabetes is probably a combination of progressive diet (especially a diet that minimizes simple carbohydrates), combined with exercise (a combination of both strength training and endurance exercise), and in some cases intermittent fasting. Many clinicians view Type II diabetes as "long term" complication of metabolic syndrome due in large part to reduced insulin sensitivity (which is in turn due to long term down regulation of insulin receptors and other factors from the chronic exposure to excess insulin secondary to a diet rich in simple carbohydrates). Under medical supervision and with sufficient compliance most cases of type II diabetes can be controlled with sufficient caloric restriction and exercise. This is perhaps why most cases of type II diabetes are reversed when people undergo bariatric surgery as shown in this meta-analysis of studies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5553790/.
4. Having said of that the study that you quote is troubling and bears further inquiry.

I just want to note that I am continuing on my medications including metformin for now as even with a diet of very low simple carbohydrate and moderate exercise my diabetes is very unstable.

Orion81RN · Dec 21, 2019

On 12/19/2019 at 4:58 AM, NormaSaline said:
I am curious what everyone thinks about the three drugs in question now (losartan, ranitidine, and metformin), and nurses' role in questioning the continued use of them.

I think my only role is to advise a concerned patient to discuss their concerns with the provider. I believe anything further would be out of line on my end. If I were a provider and knew I wanted my pt to continue their med for a good reason, I would be pretty upset if a nurse went around me and discussed possible discontinuation of a drug I outweighed the (possible) risks on. Sorry for the long run on sentence.

NormaSaline · Dec 21, 2019

23 minutes ago, myoglobin said:
4. Having said of that the study that you quote is troubling and bears further inquiry.

Exactly. That's pretty much all I'm talking about. I'm not envisioning going to a patient's bedside and saying, "hey, do you know there's carcinogens in your medication?!"

Instead, I'm asking, what is our role here? I interface with pharmacists, for example, and yet, I always forget to ask them about it. Should I bring it up to administration? I mean, shouldn't there be an overarching plan or message? But no one is talking about it at all. Hence, I brought it to this community, almost as a trial run.

I have heard of metformin as a wonder drug in terms of life extension, as well, done lots of reading and personal research. Fascinating stuff.

KimMSNDNP · Dec 29, 2019

Not all of the medications are affected just certain manufacturers...I am sure your pharmacy pulled those in question...ask your pharmacist and reassure your patient...