Avandia - Glossary

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Metformin
A type of oral anti-diabetic drug that is a part of the biguanide class of drugs. Metformin limits the amount of glucose produced in the liver and helps to increase glucose uptake by the muscles.

Avandia Case Evaluation Form

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CASE INFORMATION

Why Was Avandia Prescribed?: *
What Dosage, in Milligrams?:
How Frequently Was Avandia Taken?:
Date Patient Began Taking Avandia:

Stopped Taking Avandia:

What Symptoms Were Experienced?: *
Heart Attack
Stroke
Heart Failure

Death
Other
PPH
If "Other", Please Describe:
How Long Was it From the Last Dose to the Problems Appearing?:
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    More Than 3 Days Don't Know
Questions/Comments:

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YOUR CONTACT INFORMATION

First Name: *
Last Name: *
E-mail Address: *
Address:
City:
State: *
Zipcode:
Phone: -- xtn

CASE INFORMATION

Why Was Avandia Prescribed?: *
What Dosage, in Milligrams?:
How Frequently Was Avandia Taken?:
Date Patient Began Taking Avandia:

Stopped Taking Avandia:

What Symptoms Were Experienced?: *
Heart Attack
Stroke
Heart Failure

Death
Other
PPH
If "Other", Please Describe:
How Long Was it From the Last Dose to the Problems Appearing?:
    Within 1 Day 2 Days 3 Days
    More Than 3 Days Don't Know
Questions/Comments:
This form is secure and encrypted. More information about secure forms and your privacy here.