Metformin İlişkili Laktik Asidoz; Bir Olgu Nedeni İle Literatürün Gözden Geçirilmesi

Yıl 2020, Cilt: 3 Sayı: 1, 49 - 53, 30.03.2020

Bedih Balkan Güray Demir Fevzi Balkan Halil Çetingök Erdal Atiç

Öz

Metformin biguanid sınıfından, Tip 2 diyabetiklerde, özellikle böbrek fonksiyonları normal
hastalarda ilk basamakta kullanılan oral antidiyabetiktir. Metforminin en ciddi ve ölümcül yan
etkisi laktik asidozdur. Böbrek yetersizliği laktat atılım bozukluğunun en sık sebebidir. Acil
serviste, suisid amaçlı ilaç alımından sonra yüksek anyon açıklı metabolik asidoz varlığı olan
hastalarda metformin intoksikasyonu düşünülmelidir. 44 yaşında kadın hasta intihar amaçlı
50 gram metformin alımından 3 saat sonra acil servise bulantı ve karında şişkinlik şikâyeti
ile başvurdu. Hastada metformin ilişkili laktik asidoz (pH<7.35, laktat düzeyi>5 mmol/L ve
bikarbonat<22 mmol/L) tanımlandı. Erken tanı ve hemodiyaliz veya hemofiltrasyon yöntemleri
ile metabolik asidozun hızlı düzeltilmesi, destek tedavisi ve kan glikoz düzeyinin ayarlanması
pozitif sonuçlara neden olacaktır.

Anahtar Kelimeler

Metformin, Laktik asidoz, Hemodiyafiltrasyon

Kaynakça

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