Episode 124.0 – Metformin-Associated Lactic Acidosis

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