This week we discuss a quick case leading into the management of MALA.
Episode 124.0 – Metformin-Associated Lactic Acidosis
Core EM - Emergency Medicine Podcast
December 4, 20175m 51s
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Show Notes
Show Notes
Take Home Points
- In patients with shortness of breath and clear lungs, consider metabolic acidosis with respiratory alkalis as a potential cause
- Suspect MALA in any patient on metformin who presents with abdominal pain, nausea and vomiting and/or AMS
- Patients with MALA will have a low pH, a high-anion gap metabolic acidosis and high lactate levels
- Call your tox consultant to assist with management which will focus on fluid resuscitation with isotonic bicarbonate and dialysis
Read More
Bosse GM. Antidiabetics and Hypoglycemics. In: Hoffman RS, Howland M, Lewin NA, Nelson LS, Goldfrank LR. eds. Goldfrank’s Toxicologic Emergencies, 10e New York, NY: McGraw-Hill; 2015. Link Accessed October 31, 2017
LITFL: Metformin-Associated Lactic Acidosis
LITFL: Metformin
The Poison Review: 6 Pearls About Metformin and Lactic Acidosis
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