Episode 124.0 – Metformin-Associated Lactic Acidosis

This week we discuss a quick case leading into the management of MALA.

December 4th, 2017 Download Leave a Comment Tags: ,

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

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