A 74-year-old man with type 2 diabetes mellitus, severe peripheral vascular disease, and stage 4 chronic kidney disease (eGFR 18 mL/min/1.73m²) presents for medication adjustment. Vital signs: BP 142/88 mmHg, HR 76/min, RR 14/min, temperature 37.2°C. Recent labs show serum creatinine 3.2 mg/dL and bicarbonate 22 mEq/L. He denies chest pain or dyspnea. Which medication should be avoided due to increased lactic acidosis risk in advanced renal failure?
- A)Sitagliptin
- B)Acarbose
- C)Repaglinide
- D)MetforminGABARITO
- E)Glipizide
Explicação
Metformin is generally avoided in advanced renal dysfunction because impaired clearance increases the risk of lactic acidosis. Although many diabetes drugs require adjustment in kidney disease, this specific toxicity is a classic reason to avoid metformin in s... Ver explicação completa e trilha adaptativa →