Metformin/sertraline overdose
- PDF / 141,862 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 110 Downloads / 149 Views
1
OS
Lactic acidosis: 2 case reports A 17-year-old boy and a 34-year-old woman developed lactic acidosis after ingesting metformin alone, and metformin with sertraline, respectively, for suicidal purposes. The boy presented to an emergency department after ingesting 80 metformin 1000mg tablets [time to reaction onset not stated]. Gastric lavage was performed following insertion of a nasogastric catheter, and activated charcoal treatment was administered. Examination was notable for a state of confusion, and laboratory testing revealed blood glucose, urea, and chloride levels of 90 mg/dL, 31 mg/dL, and 99 mmol/L, respectively. Blood gas analysis showed a pH of 7.29, with a bicarbonate level, lactate level, and anion gap of 14.6, 11.5, and 27 mmol/L, respectively. Emergency dialysis was planned for severe lactic acidosis and confusion due to ingestion of metformin. A femoral catheter was placed and bicarbonate haemodialysis was implemented for 4 hours. Glucose fluid was administered to protect from hypoglycaemia. He was discharged following improvement in his clinical condition. The woman was admitted to an emergency department approximately 1 hour after ingesting 50 metformin 1000mg and 10 sertraline 50mg tablets. Gastric lavage was performed following insertion of a nasogastric catheter, and activated charcoal treatment was administered. Laboratory testing revealed blood glucose, urea, and sodium levels of 87 mg/dL, 28 mg/dL, and 131 mmol/L, respectively. Blood gas analysis was notable for a pH of 7.26, with a bicarbonate level, lactate level, and anion gap of 16.2, 4.2, and 18 mmol/L, respectively. A jugular catheter was placed and bicarbonate haemodialysis was performed for 4 hours for lactic acidosis. Glucose was administered due to the risk of hypoglycaemia. She required no further dialysis after her lactate level normalised. Hydration therapy was also administered. An improvement in her vital and laboratory findings was apparent during follow-up. She was discharged following improvement in her clinical condition. Soyoral YU, et al. Dialysis therapy for lactic acidosis caused by metformin intoxication: Presentation of two cases. Human and Experimental Toxicology 30: 1995-1997, No. 12, Dec 2011. Available from: URL: http:// 803068535 dx.doi.org/10.1177/0960327111403177 - Turkey
0114-9954/10/1395-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 31 Mar 2012 No. 1395
Data Loading...
