Metabolic effects of poisoning

Abstract 

Biochemical abnormalities due to disturbed metabolic processes are common in severely poisoned patients. These may be of diagnostic value, but most importantly their recognition and treatment are important in the management of these patients. Acid–base abnormalites, particularly respiratory and metabolic acidoses, are common. Respiratory acidoses due to central nervous system depression or pulmomary toxicity, and metabolic acidoses due to lactic acidaemia or derangements of intermediary metabolism are particular features of poisoning. Plasma electrolyte abnormalities, particularly hyper- or hypokalaemia are found commonly in poisoned patients, most often due to redistribution of potassium across cell membranes. Hypoglycaemia is most frequently due to drug overdose.

Keywords: acid–base disturbances, anion gap, hyperkalaemia, hypoglycaemia, hypokalaemia, metabolic acidosis, osmolal gap, respiratory acidosis, rhabdomyolysis