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Metformin Poisoning Management

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Metformin Litfl Life In The Fast Lane Medical Blog

Metformin rarely causes hypoglycaemia but it can cause a profound lactic acidosis in overdose and in patients with renal failure. Used therapeutically to inhibit glucogenogenesis and stimulate peripheral glucose uptake, in toxic doses it causes a profound lactaemia. All the mechanisms are unclear but it is in part due to the inhibition of gluconeogenesis (which lactate is required). Therefore in healthy individuals there is some build up of lactate, this is normally excreted in the urine but at impaired renal function or an acute overdose there is excess lactate. It is not metabolised and excretion relies solely on renal excretion A lactic acidosis in the context of therapeutic metformin has a high mortality rate and an underlying cause (sepsis) needs to be managed Metformin overdose is usually benign but doses > 10 grams are concerning Lactic acidosis will occur in these individuals who are susceptible (renal, cardiac, respiratory failure) or in patients who have ingested co-ingestants or are on medications that impair cardiac and renal function Severe lactic acidosis usually manifests with non-specific symptoms several hours later but can progress to coma, shock and death Childr Continue reading >>

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Popular Questions

  1. carwinski

    I've been on Keto for about 3 months. Not completely strict but I've done a pretty good job. Started at 205 and I am down to 180. I was never particularly heavy...I've always been athletic and an avid gym goer. So now that I am down to 180...I feel like I need some "fluff".

    I've been watching Jason Whittrock on YouTube the last 3 weeks and his intake of 4k cals per day. Then I watched him lose 2 lbs and 0.2% of body fat! Pretty amazing anyway you want to look at it. My involvement in Keto started as a need to lean out and is transforming in to a need to live longer and be healthy! I have no interest in stopping Keto but I would rather not be as lean as I am....if that makes any sense. Has anyone ever done a successful "bulk" using strict Keto?

  2. stacy

    Similar thought here. I have been keto 3.5 years, was never overweight much, went from 175 to 160 which is my high school weight. I am 16% body fat with some muscle (not a whole lot) as I work out regularly.
    I sometimes feel this is too lean but I figure it is where my body wants to be. I feel great and just plan to keep working out and maybe add some more muscle weight.

    Do you feel good and have energy? I don’t know anything really about bulking up so you might check the Keto Gains subreddit as I think they focus on that. reddit.com/r/ketogains
    9

  3. akirby83

    Are you sure you need more fat, and do you really just need more muscle? IDK how successful you would be bulking on keto, since as Jason Wittrock has proven it doesn't matter if you eat a ton of calories on LCHF, you will not gain fat. So that means adding crappy carbs back into your diet.

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