Single Dose Metformin-Induced Severe Metabolic Acidosis

Öz

Introduction: Metformin, a member of the biguanide family, is one of the most widely used drugs in the treatment of diabetes worldwide. It was first commercialized in 1957, and its use has steadily increased since then. Metformin is recommended as the first pharmacological agent in the treatment of type 2 diabetes. Case Report: 29-year-old female patient presented to our emergency department due to nausea and vomiting. In her history, she denied diarrhea, urinary symptoms suggestive of urinary tract infection, ingestion of any unusual food, use of any other medications or substances, and reported spending the entire day at home. Upon presentation, the patient was in good general condition, awake, alert, and cooperative. Later the same day (approximately 8 hours later), the patient was brought back to the emergency department via emergency medical services with decreased level of consciousness. Paramedics reported administering 50 mg intravenous dextrose due to a blood sugar level of 30 mg/dL. Conclusion: Recently, metformin has been used for weight loss as well as for therapeutic purposes. It is seen that even a single dose of metformin can cause serious side effects. People who use metformin both within and outside the indication should be careful.

Anahtar Kelimeler

• Lactic acidosis
• Metformin
• Single Dose
• MALA

Tek Doz Metformin Kullanımına Bağlı Görülen Derin Metabolik Asidoz

Öz

Giriş: Metformin biguanid ailesine ait ve dünyada diyabet tedavisinde en sık kullanılan ilaçlardan biridir. İlk kez 1957 yılında ticarileştirildi ve sonrasında kullanımı giderek arttı. Metformin tip 2 diyabet tedavisinde ilk farmakolojik ajan olarak önerilmektedir. Vaka: 29 yaşında kadın hasta acil servise bulantı kusma nedeni ile acil servisimize başvurdu. Hastanın öyküsü sorgulandığında; ishal olmadığını belirtti, üriner enfeksiyon tariflemedi, aldığı gıdalar sorgulandığında sadece kahvaltı yaptığını ve 5 adet yeşil zeytin, avuç içi kadar da ekmek yediğini belirtti, herhangi bir ilaca maruziyeti olmadığını gün boyunca evde olduğunu belirtti. Başvuru anında hastanın genel durum iyi, bilinç açık koopere ve oryante idi. Aynı günün ilerleyen saatlerinde (yaklaşık 8 saat sonra), hasta bilinç düzeyinde azalma ile acil tıbbi hizmetler aracılığıyla acil servise geri getirildi. Paramedikler, 30 mg/dL'lik kan şekeri seviyesi nedeniyle 50 mg intravenöz dekstroz uyguladıklarını bildirdi. Sonuç: Son dönemde metformin tedavi amacıyla kullanılabildiği gibi zayıflama amacıylada kullanılmaktadır.Metforminin tek doz kullanımının bile ciddi yan etkilere yol açtığı görülmektedir. Hem endikasyon dahilinde hem de endikasyon dışı metformin kullanan kişilerin dikkatli olması gerekir.

Anahtar Kelimeler

• Laktik asidoz
• Metformin
• Tek Doz
• MALA

Kaynakça

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