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What is Which of the following drugs is to be immediately stopped in a patient of diabetes with HTN and serum creatinine level of 5.6 mg? and explain in detail?
ANS. AMetformin is contraindicated in patients with high creatinine because of the risk of lactic acidosis.# Specific side effects of OHAMetformin1. GI symptoms2. B12 deficiency3. Lactic acidosis (especially in patients with high creatinine, liver failure, alcoholism, cardiorespiratory insufficiency)Piogiitazone1. Unsafe in Renal failure, Liver failure, cardiac failure2. Increased risk of bladder cancer3. OsteoporosisDPP-4 inhibitors1. Upper respiratory tract infection2. Renal toxicity (Vildagliptin is hepatotoxic)(Safest DPP-4 inhibitor in renal failure is linagliptan)(asked in Nov AIIMS 2016 and May 2017)SGLT2 inhibitors1. UTI2. Risk of bladder cancer