Core EM - Emergency Medicine Podcast

Episode 124.0 – Metformin-Associated Lactic Acidosis

Listen Later

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

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_124_0_Final_Cut.m4a
Download
2 Comments
Tags: Metformin, Toxicology
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


    Read More
    ...more
    View all episodesView all episodes
    Download on the App Store
    Core EM - Emergency Medicine PodcastBy Core EM
    • 4.5
    • 4.5
    • 4.5
    • 4.5
    • 4.5

    4.5

    245 ratings

    More shows like Core EM - Emergency Medicine Podcast

    View all
    EMCrit FOAM Feed by Scott D. Weingart, MD FCCM

    EMCrit FOAM Feed

    1,875 Listeners

    JAMA Clinical Reviews by JAMA Network

    JAMA Clinical Reviews

    500 Listeners

    The Resus Room by Simon Laing, Rob Fenwick & James Yates

    The Resus Room

    94 Listeners

    EM Clerkship by Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD

    EM Clerkship

    808 Listeners

    The Curbsiders Internal Medicine Podcast by The Curbsiders Internal Medicine Podcast

    The Curbsiders Internal Medicine Podcast

    3,377 Listeners

    Emergency Medical Minute by Emergency Medical Minute

    Emergency Medical Minute

    272 Listeners

    Core IM | Internal Medicine Podcast by Core IM Team

    Core IM | Internal Medicine Podcast

    1,148 Listeners

    The Internet Book of Critical Care Podcast by Adam Thomas & Josh Farkas

    The Internet Book of Critical Care Podcast

    697 Listeners

    The Clinical Problem Solvers by The Clinical Problem Solvers

    The Clinical Problem Solvers

    516 Listeners

    Harrison's PodClass: Internal Medicine Cases and Board Prep by AccessMedicine

    Harrison's PodClass: Internal Medicine Cases and Board Prep

    362 Listeners

    Run the List by Walker Redd, Emily Gutowski, Navin Kumar, Joyce Zhou, Blake Smith

    Run the List

    253 Listeners

    Critical Care Scenarios by Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM

    Critical Care Scenarios

    265 Listeners

    The Curious Clinicians by The Curious Clinicians

    The Curious Clinicians

    377 Listeners

    Ninja Nerd by Ninja Nerd

    Ninja Nerd

    321 Listeners

    Critical Care Time by Critical Care Time Podcast

    Critical Care Time

    273 Listeners