![]() ![]() Laboratory analysis of blood collected soon after arrival showed the following blood gas: pH 7.16, pCO2 30 mmHg and bicarbonate of 15. Cardiac telemetry monitoring showed a narrow complex sinus tachycardia. She had some self-inflicted, superficial, linear lacerations. She is alert and oriented to person, place and time without rigidity or clonus. On examination she was agitated and restless, with noted tachycardia and lungs were clear to auscultation with slightly rapid respirations. Her vital assigns upon arrival were: T 98.9 degrees Fahrenheit, HR initially 140 bpm which improved to 110 bpm soon after arrival, BP 100/50, RR 22, O2 sat 98% on room air. She has some self-inflicted superficial lacerations over her left anterior forearm. She reports having nausea and vague feelings of being unwell and is very distraught over the state of her critically ill husband. She arrives at the ED nearly 10 hours after ingestion. She was thought to have taken an unknown, but large amount of her husband’s metformin. Case presentationĪ 22-year-old female presents to the Emergency Department after being found alongside a suicide note by her family. MALA is a rare but well reported event that occurs with both therapeutic use and overdose states. It is primarily used in the treatment of diabetes but has been used in other conditions associated with insulin resistance such as polycystic ovarian syndrome. The therapeutic dosage of metformin ranges from 850 mg to a maximum of 3000 mg daily and is typically divided into twice daily dosing. Metformin is currently used extensively in the management of diabetes and is the most commonly prescribed biguanide worldwide. Phenformin, a previously used biguanide, as withdrawn from the market in the 1970’s due its association with numerous cases of lactic acidosis. In addition, metformin increases insulin sensitivity, enhances peripheral glucose utilization and decreases glucose uptake in the gastrointestinal tract. It is a member of the biguanide class and its main intended effect is expressed by the inhibition of hepatic gluconeogenesis. Metformin is a first-line agent for type 2 diabetes mellitus often used as monotherapy or in combination with oral diabetic medications. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |