Difference Between Lactic Acidosis And Ketoacidosis

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Types Of Disturbances

The different types of acid-base disturbances are differentiated based on: Origin: Respiratory or metabolic Primary or secondary (compensatory) Uncomplicated or mixed: A simple or uncomplicated disturbance is a single or primary acid-base disturbance with or without compensation. A mixed disturbance is more than one primary disturbance (not a primary with an expected compensatory response). Acid-base disturbances have profound effects on the body. Acidemia results in arrythmias, decreased cardiac output, depression, and bone demineralization. Alkalemia results in tetany and convulsions, weakness, polydipsia and polyuria. Thus, the body will immediately respond to changes in pH or H+, which must be kept within strict defined limits. As soon as there is a metabolic or respiratory acid-base disturbance, body buffers immediately soak up the proton (in acidosis) or release protons (alkalosis) to offset the changes in H+ (i.e. the body compensates for the changes in H+). This is very effective so minimal changes in pH occur if the body is keeping up or the acid-base abnormality is mild. However, once buffers are overwhelmed, the pH will change and kick in stronger responses. Remember tha Continue reading >>

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  1. meriheart

    This was from a post by JulieRN on 9/5/06. She did such a great job, I wanted it here for the record.
    Metabolic Acidosis:
    Metabolic acidosis is a pH imbalance in which the body has accumulated too much acid and does not have enough bicarbonate to effectively neutralize the effects of the acid.
    Metabolic acidosis, as a disruption of the body's acid/base balance, can be a mild symptom brought on by a lack of insulin, a starvation diet, or a gastrointestinal disorder like vomiting and diarrhea. Metabolic acidosis can indicate a more serious problem with a major organ like the liver, heart, or kidneys. It can also be one of the first signs of drug overdose or poisoning.
    Causes and symptoms
    Metabolic acidosis occurs when the body has more acid than base in it. Chemists use the term "pH" to describe how acidic or basic a substance is. Based on a scale of 14, a pH of 7.0 is neutral. A pH below 7.0 is an acid; the lower the number, the stronger the acid. A pH above 7.0 is a base; the higher the number, the stronger the base. Blood pH is slightly basic (alkaline), with a normal range of 7.36-7.44.
    Acid is a natural by-product of the breakdown of fats and other processes in the body; however, in some conditions, the body does not have enough bicarbonate, an acid neutralizer, to balance the acids produced. This can occur when the body uses fats for energy instead of carbohydrates. Conditions where metabolic acidosis can occur include chronic alcoholism, malnutrition, and diabetic ketoacidosis. Consuming a diet low in carbohydrates and high in fats can also produce metabolic acidosis. The disorder may also be a symptom of another condition like kidney failure, liver failure, or severe diarrhea. The build up of lactic acid in the blood due to such conditions as heart failure, shock, or cancer, induces metabolic acidosis. Some poisonings and overdoses (aspirin, methanol, or ethylene glycol) also produce symptoms of metabolic acidosis.
    In mild cases of metabolic acidosis, symptoms include headache, lack of energy, and sleepiness. Breathing may become fast and shallow. Nausea, vomiting, diarrhea, dehydration, and loss of appetite are also associated with metabolic acidosis. Diabetic patients with symptoms of metabolic acidosis may also have breath that smells fruity. The patient may lose consciousness or become disoriented. Severe cases can produce coma and death.
    Metabolic acidosis is suspected based on symptoms, but is usually confirmed by laboratory tests on blood and urine samples. Blood pH below 7.35 confirms the condition. Levels of other blood components, including potassium, glucose, ketones, or lactic acid, may also be above normal ranges. The level of bicarbonate in the blood will be low, usually less than 22 mEq/L. Urine pH may fall below 4.5 in metabolic acidosis.
    Treatment focuses first on correcting the acid imbalance. If the patient is diabetic, insulin may be administered. Drugs to regulate blood pressure or heart rate, to prevent seizures, or to control nausea and vomiting might be given. Vital signs like pulse, respiration, blood pressure, and body temperature will be monitored. The underlying cause of the metabolic acidosis must also be diagnosed and corrected.
    First let me differentiate between Metabolic Acidosis and Keto-Acidosis. BIG DIFFERENCE!!!
    Metabolic Acidosis is a life threatening state that if left untreated can cause death. Yes, Topamax had an alert on 12/18/03 by the FDA added that it "can cause decreased serum bicarbonate" as a risk (this is Metabolic Acidosis). However, this is really only to alert patients that have a predisposed medical condition that puts them at risk of metabolic acidosis already such as: Diabetics, renal disease, respiratory disorders, status epilepticus, diarrhea, vomiting, surgery, or a ketogenic diet (such as Atkins). Here is a link to define Metabolic Acidosis: www.findarticles.com/p/ar...2601000894
    If one is in Metabolic Acidosis for a long period of time undiagnosed it can result in Kidney stones, ostolysis (bone) (which might be something our members that are complaining of bone pain might want to get checked out for). Severe can cause respiratory failure or death. Metabolic Acidosis is a side effect of keto-acidosis, but by itself, in no way causes weight loss.
    Now for the Keto-Acidosis. This is a state that one goes into to cause weight loss. This is the Atkins diet theory. Low carb, high protein. It is similar (but not exact) to what happens to a diabetic when they are in Diabetic Ketosis, however we "cause" it to happen by our diet. Topamax DOES NOT CAUSE THIS. This can only be brought on by diet or starvation. Again, Metabolic Acidosis is a side effect when we are in Keto-Acidosis. We need to watch for the severe signs and symptoms while in this state. Keto-Acidosis CAUSES WEIGHT LOSS. Our body uses carbs for energy, when we don't have them our body then uses fat. The bi-product when we are (burning) using fat is Ketones in our urine. Thus - Keto-Acidosis.
    In general: Topamax does not cause one to go into Metabolic Acidosis (for the most part) but it can be a risk to some patients. Metabolic Acidosis DOES NOT cause weight loss. It can be life threatening if severe, and should be monitored for periodically by your PCP while on Topamax.
    Keto-Acidosis is the Atkins type of Acidosis that most people are familiar with. NO Topamax does not cause this either. Diet is the only thing that can bring this state on. Being in Keto-Acidosis puts you at increased risk of Metabolic Acidosis.
    I hope I was able to explain this so everyone was able to understand, if not let me know. I will try again!!!

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