173 results
Metformin Associated Lactic Acidosis (MALA) 

Pathophysiology of MALA
 - Metformin interferes with the activity of the
Metformin Associated ... Pathophysiology of MALA - Metformin ... recycles peripheral lactate ... production  increased lactate ... Kat_Watson #MALA #Metformin
Lactic Acidosis Classification - Type A vs Type B
Type A Lactic Acidosis: Sepsis, Ischemic bowel, Hemorrhagic
Short bowel (D-lactate ... Renal failure, Metformin
Lactic Acidosis - Classification and Differential Diagnosis
Type A Lactic Acidosis: Inadequate Oxygen Delivery
 • Anaerobic muscular
Fructose, Isoniazid, Lactate-based ... dialysate, Metformin ... #TypeA #TypeB #lactate
Lactic Acidosis - Differential Diagnosis Framework

Type A: Impaired O2 Delivery (DO2)
 • Decreased O2 Delivery: Hypotension
Acid, Biguanides (Metformin ... with negative lactate ... requires separate D-lactate ... sugars into D-Lactate ... #criticalcare #lactate
Causes of Lactate Elevation, Lactic Acidosis - Differential Diagnosis

The most common causes of hyperlactatemia are usually:
Causes of Lactate ... categories Lactate ... The use of lactate ... With ↑ Lactate ... and Toxins: - Metformin
Type B Lactic Acidosis
Elevated lactic acid when no systemic hypoperfusion is apparent
Causes:
 • Drugs (metformin, linezolid,
Causes: • Drugs (metformin ... to clear) • D-lactate
Diabetes Combination Tablets - Estimated A1c Lowering 
Metformin + DPP4 
• Janumet (metformin + sitagliptin) 
•
A1c Lowering Metformin ... DPP4 • Janumet (metformin ... • Jentadueto (metformin ... • Kombiglyze (metformin ... saxagliptin) Metformin
Crystalloid Composition - Normal Saline, Ringer's Lactate, Hartmann's Solution, PlasmaLyte

Ca2+ Mg2+ Cl- 
Acetate 
Lactate 
Gluconate 
Bicarbonate
Saline, Ringer's Lactate ... Ca2+ Mg2+ Cl- Acetate ... Lactate Gluconate ... #LR #Ringers #Lactated
Metformin 
Current Renal Dose Adjustments due to Risk of Lactic Acidosis 
> 60 No adjustment 
45-60
Metformin Current ... already taking metformin ... /ambcarerx #Metformin
Lactated Ringers (LR) vs Normal Saline (NS) - Comparison

Composition of LR:
 • Sodium 130 mEq/L
 •
Lactated Ringers ... mEq/L • Sodium lactate ... pH of 4-7.5 Lactated ... mEq • Sodium Lactate ... mole/L of sodium lactate