METFORMIN POISONING AND METFORMIN ASSOCIATED LACTACIDOSIS
| Autor: | JASMIN HAMZIĆ, KATJA KUDRNA-PRAŠEK, IVAN GORNIK |
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| Jazyk: | chorvatština |
| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | Acta medica Croatica : Časopis Akademije medicinskih znanosti Hrvatske Volume 74 Issue Supl 1 |
| ISSN: | 1848-8897 1330-0164 |
| Popis: | Svrha ovog rada je prikaz neobičnog slučaja otrovanja metforminom s razvojem laktacidoze, koji je uspješno liječen u hitnom prijmu. Dijabetičar u dobi od 65 godina koji je u terapiji imao metformin dovezen je u noćnim satima u hitni prijam zbog traume glave. Nađene su niske vrijednosti glukoze u kapilarnoj krvi, koje su se normalizirale nakon primjene glukoze intravenski. Nakon udarca u glavu zaostao je nejasan kvalitativni poremećaj svijesti, a u acidobaznom statusu smo našli tešku acidozu s proširenim anionskim zjapom i povišenim laktatima. Na agresivne potporne mjere došlo je do stabilizacije acidobaznog statusa, a nakon dugotrajne opservacije pacijent je otpušten iz hitnog prijma. Ovakvo otrovanje metforminom je neobična i atipična klinička prezentacija koja je mogla lako završiti smrtnim ishodom. U prikazu slučaja dajemo recentne preporuke o prepoznavanju, obradi i liječenju ovog za život opasnog stanja. The objective of this case report is to present a patient with metformin poisoning, and to highlight treatment and potential pitfalls. A 65-year-old patient was admitted to Emergency Department (ED) with head injury. He was hypoglycemic and received IV glucose, but altered consciousness persisted. His arterial blood gas analysis showed deep acidemia with high lactate levels. After aggressive treatment, his pH improved, and after prolonged 36-hour observation in ED, lactate levels dropped to normal, he was feeling better and was discharged home. This was an unusual presentation of metformin toxicity, which is usually life threatening, therefore we try to point out how to manage and recognize patients like this one in ED. |
| Databáze: | OpenAIRE |
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