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Metformin is an unusual drug in that high concentrations are retained in the walls of the gastrointestinal tract.
Also, the same blood levels of metformin can lead to different glucose-lowing effects, according to whether the drug is administered orally, intravenously, or via the portal vein.
 
Below is a quote from a very interesting paper to be found at http://dmd.aspetjournals.org/cgi/content/full/30/8/861
 
...Despite the similarity in the concentration-time profiles obtained for different routes of metformin administration, intraduodenal administration produced larger response than intraportal metformin infusion, and lowest response was observed following intravenous administration. This finding indicates that a significant "first-pass" pharmacodynamic effect, which occurs in the presystemic sites of action (liver and the gastrointestinal wall), contributes to the overall glucose-lowering response of metformin. We applied a combined pharmacokinetic-pharmacodynamic modeling approach to study the nature of the first-pass pharmacodynamic effect. The observed data were successfully described by a novel integrated indirect response pharmacokinetic-pharmacodynamic model that revealed a correlation between the temporal metformin concentrations that transit the portal vein and through the gut wall rather than with drug concentrations that accumulated in the liver and the intestinal wall....
 
Robin

Dr R.P.M. Marks
Consultant Chemical Pathologist
Pathology
Calderdale Royal Hospital
Halifax
HX3 0PW

-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]]On Behalf Of Ian Holbrook
Sent: 08 June 2007 09:53
To: [log in to unmask]
Subject: metformin analysis

Dear all

Is there anyone in the UK who would be able to measure metformin in the serum from a patient who is currently on our ICU?

Kind regards

Ian

Dr Ian Holbrook
Dept. Clinical Biochemistry
York Hospital
Wigginton Road
York YO31 8HE
UK
01904 725786

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------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/