Anion gap usmle - anion gap metabolic acidosis normal anion gap metabolic acidosis
Drug And Chemical-induced Metabolic Acidosis.
Abstract Metabolic acidosis produced by drugs and/or chemicals can be conveniently divided into those with an increase in the anion gap (anion gap = Na- (Cl + HCO3)) and those with a normal anion gap. The increase in the anion gap is due to the accumulation of unmeasured organic anions, such as lactate or acetoacetate and beta-hydroxybutyrate, as occurs in ketoacidosis and lactic acidosis, or the accumulation of toxic anions such as formate or glycolate, as occurs with the ingestion of methanol or ethylene glycol. Increased concentrations of lactic acid may also be present in the toxic forms of metabolic acidosis. The most common drugs and chemicals that induce the anion gap type of acidosis are biguanides, alcohols, polyhydric sugars, salicylates, cyanide and carbon monoxide. In normal anion gap acidosis the reduction in bicarbonate is balanced by a reciprocal increase in the chloride concentration so that the sum of the two remains unchanged. Normal anion gap acidosis is caused by carbonic anhydrase inhibitors, hydrochloride salts of amino acids, toluene, amphotericin, spironolactone and non-steroidal anti-inflammatory drugs. The mechanism by which these substances produce metabo
Quickest Way to Flush Your BODY CLEAN of TOXINS. Help PREVENTS CANCER & REMOVE TOXIN from LIVER, COLON. On any given day, you may be exposed to any number of the 80,000-plus industrial chemicals in use today. Another 1,000 chemicals or so are introduced every year, according to Brenda Watson, a certified nutritional consultant and author of The Detox Strategy. These toxic substances lurk everywherein the air, water, household cleaners, perfumes, food and childrens toys. While the process of detox has its critics, natural health professionals extol its benefits for helping your body to expel toxins. Step 1 Reduce the amount of toxins you take in on a daily basis. Its self-defeating to do a detox if youre still taking in a significant amount of toxins, points out Peter Bennett, a naturopathic doctor and author of The Purification Plan. Switch to organic foods and beverages and drink filtered or distilled water. Avoid using products that contain toxins, such as household cleaners, inorganic cosmetics and perfumes, and avoid exposure to cigarette smoke or other airborne chemicals. Step 2 Eat about 30 to 40 grams of fiber daily. As Ann Louise Gittleman puts it in her book The Fast Track One-Day Detox Diet, "The colon is the garbage dump in your system, but fiber acts as a garbage truck hauling away the toxic waste." Organic vegetables, fruits and whole grains are good sources. Step 3 Drink a glass of cranberry juice combined with orange juice daily. Both juices are loaded with antioxidants that fight free radicals. Cranberry juice also enables the liver to break down fat more efficiently and contains a key ingredient, arbutin, which acts as a diuretic and draws out toxins to be excreted, according to Gittleman. Step 4 Drink at least eight 8 oz. glasses of purified water each day to increase kidney activity and speed up the removal of toxins. Water will also prevent constipation from your increased fiber intake. Step 5 Exercise for at least 30 minutes every day. When you dont exercise, the lymphatic systemwhich keeps your immune system working at peak conditionbecomes stagnant, causing waste to spill over into your body, Bennett explains. Exercise also increases sweating, which also effectively removes toxins. Step 6 Treat yourself to a full-body rub down with an organic sea salt scrub. According to Bennett, salts have detoxifying qualities and increase perspiration. They also exfoliate your skin to remove dead skin cells and dirt that may be blocking pores on your skin, another powerful detoxification organ in your body. Things You'll Need Dietary fiber Cranberry juice Orange juice Purified water Sea salt scrub Air purifier Tips Practice meditation or deep breathing for at least 15 minutes a day during your detox, which can be stressful. Also, it can help to offset detox side effects such as hunger pangs, according to Gittleman. Turn on an air purifier to eliminate airborne toxins in your home. Warnings If you have a disease or medical condition, consult your doctor before attempting a detoxification treatment.
Metabolic Acidosis Due To Drugs And Toxins
220.127.116.11.Metabolic Acidosis due to Drugs and Toxins Metabolic Acidosis due to Drugs and Toxins Several drugs and toxins have been implicated as direct or indirect causes of a high-anion gap metabolic acidosis (HAGMA). A consideration of these drugs needs to be included in an differential diagnosis of a HAGMA. The three most common ones to consider are methanol, ethylene glycol and salicylates. Other toxins which can cause acidosis are isopropyl alcohol and butoxyethanol. Toluene also causes an acidosis and the anion gap may be normal or elevated. * Initially no acid-base disorder due to long latent period while methanol is metabolised * Later, typically develop a high anion gap metabolic acidosis -due to formic acid * May also develop a respiratory acidosis secondary to CNS depression (with depression of respiratory centre and/or airway obstruction) * May occasionally present with normal anion gap acidosis if smaller ingestion * If patient is an alcoholic, there may other types of acidosis present as well (eg alcoholic ketoacidosis, starvation ketoacidosis, lactic acidosis, respiratory acidosis due aspiration, respiratory alkalosis due chronic liver disease.) Principles of Treatmen
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 acidosis occurs when the body produces too much acid. It can also occur when the kidneys are not removing enough acid from the body. There are several types of metabolic acidosis. Diabetic acidosis develops when acidic substances, known as ketone bodies, build up in the body. This most often occurs with uncontrolled type 1 diabetes. It is also called diabetic ketoacidosis and DKA. Hyperchloremic acidosis results from excessive loss of sodium bicarbonate from the body. This can occur with severe diarrhea. Lactic acidosis results from a buildup of lactic acid. It can be caused by: Alcohol Cancer Exercising intensely Liver failure Medicines, such as salicylates Other causes of metabolic acidosis include: Kidney disease (distal renal tubular acidosis and proximal renal tubular acidosis) Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol
(Usually in clinical practice, H+ concentration is expressed as pH.) PaCO2 (Arterial CO2 concentration normal = 3545 mm Hg). HCO3 (Serum electrolytes normal = 2231 mmol/liter). Acidosis is a process that causes the accumulation of acid. Alkalosis is a process that causes the accumulation of alkali. The most common causes in the surgical practice include: Diuretic therapy (e.g., contraction alkalosis). Acid loss through GI secretions (e.g., nasog ...
Abstract The incidence of acid-base disorders (ABDs) is high, especially in hospitalized patients. ABDs are often indicators for severe systemic disorders. In everyday clinical practice, analysis of ABDs must be performed in a standardized manner. Highly sensitive diagnostic tools to distinguish the various ABDs include the anion gap and the serum osmolar gap. Drug-induced ABDs can be classified into five different categories in terms of their pa ...
Abstract Metabolic acidosis produced by drugs and/or chemicals can be conveniently divided into those with an increase in the anion gap (anion gap = Na- (Cl + HCO3)) and those with a normal anion gap. The increase in the anion gap is due to the accumulation of unmeasured organic anions, such as lactate or acetoacetate and beta-hydroxybutyrate, as occurs in ketoacidosis and lactic acidosis, or the accumulation of toxic anions such as formate or gl ...
Treatment of Acidosis: Sodium Bicarbonate and Other Drugs Lactic acidosis, defined as a lactate level > 5 mmol/1 and a pH 7.35, is far and away the most-important acidosis during critical illness and most of this discussion of acidosis treatment will focus on treatment of lactic acidosis. Even in the face of maximal supportive therapy, lactic acidosis is associated with a mortality of 60-90% [ 1 , 2 , 3 , 4 ], so physicians have long relied on t ...
Gary P. Carlson, Michael Bruss, in Clinical Biochemistry of Domestic Animals (Sixth Edition) , 2008 Mixed acid-base disorders occur when several primary acid-base imbalances coexist (de Morais, 1992a). Metabolic acidosis and alkalosis can coexist and either or sometimes both of these metabolic abnormalities may occur with either respiratory acidosis or alkalosis (Nairns and Emmett, 1980; Wilson and Green, 1985). Evaluation of mixed acid-base abn ...
Metabolic Acidosis Respiratory compensation for metabolic disorders is quite fast (within minutes) and reaches maximal values within 24 hours. A decrease in Pco2 of 1 to 1.5 mm Hg should be observed for each mEq/L decrease of in metabolic acidosis.27 A simple rule for deciding whether the fall in Pco2 is appropriate for the degree of metabolic acidosis is that the Pco2 should be equal to the last two digits of the pH. For example, compensation is ...