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Acetazolamide Metabolic Acidosis Anion Gap

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What is ALKALOSIS? What does ALKALOSIS mean? ALKALOSIS meaning - ALKALOSIS pronunciation - ALKALOSIS definition - ALKALOSIS explanation - How to pronounce ALKALOSIS? Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Alkalosis is the result of a process reducing hydrogen ion concentration of arterial blood plasma (alkalemia). In contrast to acidemia (serum pH 7.35 or lower), alkalemia occurs when the serum pH is higher than normal (7.45 or higher). Alkalosis is usually divided into the categories of respiratory alkalosis and metabolic alkalosis or a combined respiratory/metabolic alkalosis. Respiratory alkalosis is caused by hyperventilation, resulting in a loss of carbon dioxide. Compensatory mechanisms for this would include increased dissociation of the carbonic acid buffering intermediate into hydrogen ions, and the related excretion of bicarbonate, both of which lower blood pH. Hyperventilation-induced alkalosis can be seen in several deadly central nervous system diseases such as strokes or Rett syndrome. Metabolic alkalosis can be caused by repeated vomiting, resulting in a loss of hydrochloric acid within the stomach content. Severe dehydration, and the consumption of alkali are other causes. It can also be caused by administration of diuretics and endocrine disorders such as Cushing's syndrome. Compensatory mechanism for metabolic alkalosis involve slowed breathing by the lungs to increase serum carbon dioxide, a condition leaning toward respiratory acidosis. As respiratory acidosis often accompanies the compensation for metabolic alkalosis, and vice versa, a delicate balance is created between these two conditions. Metabolic alkalosis is usually accompanied by low blood potassium concentration, causing, e.g., muscular weakness, muscle pain, and muscle cramps (from disturbed function of the skeletal muscles), and muscle spasms (from disturbed function of smooth muscles). It may also cause low blood calcium concentration. As the blood pH increases, blood transport proteins, such as albumin, become more ionized into anions. This causes the free calcium present in blood to bind more strongly with albumin. If severe, it may cause tetany.

Acid/base Disorders: Metabolic Alkalosis

Does this patient have metabolic alkalosis? How does one make the diagnosis of metabolic alkalosis and differentiate simple from mixed disturbances? Metabolic alkalosis is due either to a gain in bicarbonate or a bicarbonate precursor (HCO3-), loss of hydrogen ion (H+) or the loss of fluid that contains Cl- in higher concentration and bicarbonate in lower concentration than serum. The brainstem is sensitive to interstitial and cellular H+changes and the decline in H+with metabolic alkalosis inhibits ventilation (respiratory compensation). In simple metabolic alkalosis the resultant compensatory alveolar hypoventilation leads to an increase in arterial carbon dioxide content (PaCO2). For each 1 mEq/L rise in HCO3-, PaCO2 rises about 0.7 mmHg (range 0.6-1.0 mmHg). Based on the history, one can assess whether an increase in HCO3-is due to oral or intravenous alkali administration vs. H+ loss that results in addition of HCO3- to the body. The kidney plays a crucial role in maintaining HCO3-. Most often, the kidneys can excrete excess HCO3- and bicarbonaturia occurs. Factors that facilitate bicarbonaturia are adequate extracellular fluid (ECF) volume, dietary salt intake, potassium bal Continue reading >>

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Popular Questions

  1. Binti1962

    Does it matter when to test blood ketones?

    Just received a new blood ketone meter and the strips are arriving today so I haven't used it yet. Does it matter when I test? There were no guidelines with the meter. Thanks!
    Binti
    Sent from my iPhone using Diabetes Daily

  2. jwags

    I bought a ketone meter several years ago. I would test in the mornings once or twice a week. The strips are very expensive. I finally gave up because my ketone level was always very low, even doing a Ketogenic diet.

  3. furball64801

    Are you on a ketogenic diet to see if you are burning fat. You can get urine sticks that would do about the same job and are cheaper. I used those 45 yrs ago before I became diabetic and lost 10 lbs but was only 170 at the time.

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Metabolic Acidosis And Hyperventilation Induced By Acetazolamide In Patients With Central Nervous System Pathology

ACETAZOLAMIDE, a carbonic anhydrase inhibitor, is used in patients with meningeal inflammation, mild intracranial hypertension, and basal skull fractures to decrease the formation of cerebrospinal fluid (CSF). It causes mild metabolic acidosis by inhibiting the reabsorption of bicarbonate (HCO−3) ions from renal tubules. This effect has been used successfully in the treatment of patients with chronic respiratory acidosis with superimposed metabolic alkalosis 1 and central sleep apnea syndrome. 2 Life-threatening metabolic acidosis during acetazolamide therapy has been observed only in patients with renal impairment or 3 diabetes 4 and in elderly patients. 5 Severe metabolic acidosis, associated with acetazolamide, in the absence of other predisposing factors has not been reported in patients with central nervous system disease. We report three cases of severe metabolic acidosis and hyperventilation during acetazolamide therapy in normal doses in adult patients without renal impairment. A 35-yr-old man with a head injury underwent craniotomy for evacuation of a traumatic left temporal extradural hematoma. Postoperatively, the patient underwent mechanical ventilation to maintain a Continue reading >>

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  1. pixiejenna

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    Mediana said: ↑
    Looks Yummy, I'm gonna try the cheese crust What didn't you like about the seasoning? I can't really pin point it to be honest they were all the right spices but it didn't taste Mexican too me it was a little bland not enough flavor for me. I really like Trader Joe's taco seasoning but it's spicy as heck I usually only use 1/3 -1/2 of a packet.
    dollfeet said: ↑
    Oooh I think I'm going to make that chili this weekend. Question - with the jalapeños how spicy is it? (I want to make sure the child will eat it too). I don't think it's spicy but you can always omit the jalapeños it won't change the flavor much imo. If spicy is a issue I'd also recommend using one less table spoon of chili powder. I usually use about 3.5 using 4 is a but much for me and I thought 3 wasn't enough. So maybe start with 3 and adjust as needed. Also remember if it's too spicy for your kid add extra sour cream and cheese to their serving to help tone it down. I make this chili a few times a month and everyone whose tried it loves it. I am not exaggerating at all I actually have coworkers who ask me to bring them some every time I make it. The only other thing I do different is most people drain the fat from the ground beef when they put it in the crock pot I dump everything into the crock pot. I also buy minced garlic to make life easier lol.

  2. pixiejenna

    Keto bars update I ordered them Sunday evening and I got them Wednesday which is pretty darn quick! I took pictures of them to share. My initial thought when I got them when I saw the box is they are going to be small and they are. As far as taste goes they are okay. I'm a little disappointed because a lot of the reviews said that they taste like brownies and imo they did not. They really reminded me of a mounds bar but with less coconut and more chocolate flavor. They do have a very distinct coconut flavor so if that's a flavor that you don't like I'd recommend skipping them. I am also feeling a bit under the weather so, I'll post another update after I finish them on my thoughts on them. My opinion on the flavor may change since I'm not 100% at the moment.

  3. Mediana

    I would love to be able to order something like that here in Sweden!

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What is BASAL METABOLIC RATE? What does BASAL METABOLIC RATE mean? BASAL METABOLIC RATE meaning - BASAL METABOLIC RATE definition - BASAL METABOLIC RATE explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. Basal metabolic rate (BMR) is the minimal rate of energy expenditure per unit time by endothermic animals at rest. It is reported in energy units per unit time ranging from watt (joule/second) to ml O2/min or joule per hour per kg body mass J/(hkg)). Proper measurement requires a strict set of criteria be met. These criteria include being in a physically and psychologically undisturbed state, in a thermally neutral environment, while in the post-absorptive state (i.e., not actively digesting food). In bradymetabolic animals, such as fish and reptiles, the equivalent term standard metabolic rate (SMR) is used. It follows the same criteria as BMR, but requires the documentation of the temperature at which the metabolic rate was measured. This makes BMR a variant of standard metabolic rate measurement that excludes the temperature data, a practice that has led to problems in defining "standard" rates of metabolism for many mammals. Metabolism comprises the processes that the body needs to function. Basal metabolic rate is the amount of energy expressed in calories that a person needs to keep the body functioning at rest. Some of those processes are breathing, blood circulation, controlling body temperature, cell growth, brain and nerve function, and contraction of muscles. Basal metabolic rate (BMR) affects the rate that a person burns calories and ultimately whether that individual maintains, gains, or loses weight. The basal metabolic rate accounts for about 60 to 75% of the daily calorie expenditure by individuals. It is influenced by several factors. BMR typically declines by 12% per decade after age 20, mostly due to loss of fat-free mass, although the variability between individuals is high. The body's generation of heat is known as thermogenesis and it can be measured to determine the amount of energy expended. BMR generally decreases with age and with the decrease in lean body mass (as may happen with aging). Increasing muscle mass has the effect of increasing BMR. Aerobic (resistance) fitness level, a product of cardiovascular exercise, while previously thought to have effect on BMR, has been shown in the 1990s not to correlate with BMR when adjusted for fat-free body mass. But anaerobic exercise does increase resting energy consumption (see "aerobic vs. anaerobic exercise"). Illness, previously consumed food and beverages, environmental temperature, and stress levels can affect one's overall energy expenditure as well as one's BMR. BMR is measured under very restrictive circumstances when a person is awake. An accurate BMR measurement requires that the person's sympathetic nervous system not be stimulated, a condition which requires complete rest. A more common measurement, which uses less strict criteria, is resting metabolic rate (RMR).

Metabolic Alkalosis

Metabolic alkalosis is common—half of all acid-base disorders as described in one study (1). This observation should not be surprising since vomiting, the use of chloruretic diuretics, and nasogastric suction are common among hospitalized patients. The mortality associated with severe metabolic alkalosis is substantial; a mortality rate of 45% in patients with an arterial blood pH of 7.55 and 80% when the pH was greater than 7.65 has been reported (2). Although this relationship is not necessarily causal, severe alkalosis should be viewed with concern, and correction by the appropriate intervention should be undertaken with dispatch when the arterial blood pH exceeds 7.55. Metabolic alkalosis occurs when a primary pathophysiologic process leads to the net accumulation of base within or the net loss of acid from the extracellular fluid (ECF); typically, the intracellular compartment becomes more acidic in potassium-depletion alkalosis (3). Unopposed by other primary acid-base disorders, metabolic alkalosis is recognized by increases in both arterial blood pH—alkalemia—and plasma bicarbonate concentration. The increase in arterial blood pH promptly, normally, and predictably de Continue reading >>

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  1. Daytona

    Quote:

    Originally Posted by moon
    Good news on the 3 down - here's hoping the other 3 march out the door tomorrow.
    Since the .4 was fasting, did you really go out of ketosis, or are just mildly in it. In spite of the weaknesses of Ketostix, I wonder if you would have registered a color. I ran out of those and need to get some more. Jimmy highlighted how urine and blood don't correlate, but aren't they still good for 'yes' answer if there's a color? Out of ketosis was probably a poor term on my part. What I meant is that I went from making adequate ketones to ramping down ketone production. Lately my fasting ketones have been > 1.5, so to go back down to .4 seems significant. My ketostix have all expired so I'm not sure what they would report.
    We'll see what tomorrow brings!

  2. grammaB

    Today's numbers:
    fbg: 78
    ketones: 3.9
    weight: no change
    I messed up one strip and had to use a second! I was using non dominant hand to draw up the blood drop and I hit the strip knocking it out. There was a tiny bit of blood on it, I tried to reinsert it and the meter literally spit it out, twice!! Wow.
    Yesterday:
    fat: 158.2
    protein: 71.07
    carb 15.9
    calories: 2067.6
    K/R: 2.4
    Had a big, juicy, fatty, 6oz rib eye for dinner and just couldn't cut that baby in half!! It was tooooo good!!
    I am anxiously awaiting your program too Daytona. If it does fractions/decimal points I can finally drop the hand written journal on top of myfitnesspal.......maybe even myfitnesspal too. I am sure looking to streamline this record keeping process as much as possible. Does it store the foods or better yet meals so each time it doesn't have to be input again? Oh and big question, will it work on a mac?

  3. grammaB

    Quote:

    Originally Posted by David Burke
    I think so. I'd rather spend 10 bucks for 50 sticks and look for excess ketones than spend the 2+ bucks/strip for a definite ratio.
    But that's my preference
    Sent from my iPhone
    I use both right now, the meter for fasting and the sticks at bedtime. I am almost always in the darkest two colors on the stick. Once I know that most of my regular meals will keep me well into ketosis, I will test with the meter much less often and basically use the sticks to stay on top of it.
    OT a little, does anyone know if Costco has the keto sticks??

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