Question
Download Solution PDFWhich among the following is contra indicated in patients with eGFR less than 15mg/ml/1.75m 2 ?
This question was previously asked in
ISRO Pharmacist Previous Year Question paper 2021
Answer (Detailed Solution Below)
Option 2 : Metformin
Free Tests
View all Free tests >
RRB Pharmacist ST 1: Human Anatomy and Physiology
11.7 K Users
20 Questions
20 Marks
18 Mins
Detailed Solution
Download Solution PDFCorrect Answer: Metformin
Rationale:
- Metformin is contraindicated in patients with an estimated Glomerular Filtration Rate (eGFR) less than 15 mL/min/1.73 m². This is due to the increased risk of lactic acidosis, a rare but serious complication that can occur due to the accumulation of metformin in patients with significant renal impairment.
- Lactic acidosis is characterized by elevated levels of lactic acid in the blood, leading to symptoms such as muscle pain, respiratory distress, abdominal pain, and severe fatigue. In severe cases, it can be life-threatening.
- The kidneys are responsible for excreting metformin, and when kidney function is severely reduced, the drug can accumulate to dangerous levels. Therefore, it is critical to assess kidney function before and during the treatment with metformin.
Explanation of Other Options:
Insulin
- Rationale: Insulin is not contraindicated in patients with low eGFR. It is a necessary treatment for managing blood glucose levels in patients with diabetes, including those with severe kidney impairment. Insulin dosing may need to be adjusted based on the patient’s renal function, but it is not inherently dangerous in this population.
Linagliptin
- Rationale: Linagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor used to manage blood glucose levels in patients with type 2 diabetes. Unlike metformin, linagliptin is not contraindicated in patients with low eGFR because it is primarily excreted via the bile and not the kidneys. This makes it a safer option for patients with renal impairment.
None of the above
- Rationale: This option is incorrect because, as explained, metformin is indeed contraindicated in patients with an eGFR less than 15 mL/min/1.73 m² due to the risk of lactic acidosis. Therefore, "None of the above" is not the correct answer.
Conclusion:
- Among the given options, metformin is the only medication contraindicated in patients with an eGFR less than 15 mL/min/1.73 m² due to the risk of lactic acidosis. Insulin and linagliptin can be used in patients with severe renal impairment, although dose adjustments may be necessary for insulin.
Last updated on May 15, 2025
-> The RRB Pharmacist Response Sheet objection link has been reopened till 20th May 2025.
-> The CBT for the Railway Pharmacist Exam was conducted from 28th April to 30th April 2025.
-> The RRB Pharmacist Recruitment is ongoing for 246 vacancies for the post of Pharmacist (Entry Grade).
-> The selection process includes a Computer Based Test, Document Verification & Medical Examination.