A patient is posted for elective surgery. Which of the following drugs should be stopped on the day of surgery: (AIPG 2012)
a. The major toxicity of metformin, lactic acidosis, can be prevented by careful patient selection. Metformin should not be used in patient with renal insufficiency [serum creatinine> 133 Umol/L (1.5mg/dL) in men or >124 Umo/L (1.4 mg/dL) in women, with adjustments for age].
b. Any form of acidosis, congestive heart failure, liver disease, or severe hypoxia. Metformin should be discontinued in patient who are seriously ill in patients who can take nothing orally and in those receiving radiographic contrast material. Insulin should be used until metformin can be restarted.
c. It should not be used in patient with liver disease or heavy ethanol intake.