Lactic acidosis can be a complication of which medication usage?

Lactic acidosis can be a complication of which medication usage?

• A. Insulin
• B. Metformin
• C. Heparin
• D. Vitamin C

Answer: (B)

Metformin is the medication classically associated with lactic acidosis. This occurs especially when kidney function is impaired or tissues are in a state of hypoxia or dehydration. Metformin inhibits mitochondrial respiration and decreases hepatic lactate uptake, leading to increased lactate production and reduced clearance. The result is a high anion gap metabolic acidosis with elevated lactate levels. Clinically, patients may have malaise, abdominal discomfort, tachypnea, and signs of acidosis, and the condition can be life-threatening if not recognized. Discontinuing metformin and addressing the precipitating factors is essential, with renal replacement therapy considered in severe cases to remove metformin and correct the acidosis. Other listed medications do not characteristically cause lactic acidosis as a primary complication.

Metformin is the medication classically associated with lactic acidosis. This occurs especially when kidney function is impaired or tissues are in a state of hypoxia or dehydration. Metformin inhibits mitochondrial respiration and decreases hepatic lactate uptake, leading to increased lactate production and reduced clearance. The result is a high anion gap metabolic acidosis with elevated lactate levels. Clinically, patients may have malaise, abdominal discomfort, tachypnea, and signs of acidosis, and the condition can be life-threatening if not recognized. Discontinuing metformin and addressing the precipitating factors is essential, with renal replacement therapy considered in severe cases to remove metformin and correct the acidosis. Other listed medications do not characteristically cause lactic acidosis as a primary complication.