Metformin_Associated_Lacitic_Acidosis

Metformin_Associated_Lacitic_Acidosis - Metformin...

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Unformatted text preview: Metformin Associated Lactic Acidosis Jun-Ki Park 9/6/11 Probably the most common mechanism by which metformin elevates blood lactate is by inducing catecholamine release in those who regulate or prescribe it Peter W Stacpoole, Editorial, Diabetes Care 1998 Incidence: estimated 2-10 patients per 100,000 patients receiving metformin per year. MALA accounts for approximately 0.1-1% of total patients admitted to ICU. Life-threatening condition with mortality rate of 30-50%. Nearly all of the reported cases of MALA have occurred in individuals with both hemodynamic (e.g. hypotension) and metabolic (e.g. liver or renal disease) underlying causes of impaired lactate metabolism. Controversy remains whether the use of metformin is a cause or a coincidence in lactic acidosis of DM patients. LA Rates in T2DM Before Introduction of Metformin Brown et al. Diabetes Care 1998 Biguinides Pharmacokinetic Aspects of Metformin Bioavailability 5060 percent; absorbed mainly from the small intestine; estimated absorption half-life, 0.9 to 2.6 hours Plasma concentration Maximal, 1 to 2 m g per milliliter (approximately105M) 1 to 2 hours after an oral dose of 500 to 1000 mg; negligible binding to plasma proteins Plasma half-life Estimated at 1.5 to 4.9 hours Metabolism Not measurably metabolized Elimination About 90 percent is eliminated in urine in 12 hours; multiexponential pattern involving glomerular filtration and tubular secretion...
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Metformin_Associated_Lacitic_Acidosis - Metformin...

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