Metformin overdose
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Lactic acidosis: case report A 51-year-old man developed lactic acidosis after an accidental metformin overdose [time to onset not stated]. The man, who had a history of hypertension, diabetes mellitus, and alcohol abuse, was found unresponsive at home by emergency medical services. He had agonal breathing and required intubation. Tests revealed the following: BP 56/30mm Hg, blood glucose 22 mg/dL, pH 6.5, lactic acid 21.5 mg/dL, creatinine 2.4 mg/dL, and bicarbonate < 5 mEq/L. His medications included oxycodone/paracetamol [acetaminophen] and metformin [route, dosage, and duration of therapy not stated]. It was suspected that he had mistakenly been taking metformin every 6 hours [dose not stated] instead of his oxycodone/ paracetamol for pain relief. His family corroborated this and analysis revealed a metformin blood level of 12 mcg/mL (normal range 1–2 mcg/mL). The man underwent one session of continuous renal replacement therapy and he was extubated 3 days later. On discharge, his BP, respiratory status, and kidney function were improved. He was prescribed gabapentin and morphine for his neuropathic pain and chronic pain, respectively. Cosenza L, et al. A potentially fatal case of mistaken identity: Metformin vs oxycodone-acetaminophen. Journal of Investigative Medicine 59: 385 abstr. 48, No. 2, Feb 2011. Available from: URL: http://dx.doi.org/10.231/ 803061272 jim.0b013e31820bab4c - USA
0114-9954/10/1373-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 15 Oct 2011 No. 1373
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