UMEM Educational Pearls

Category: Toxicology

Title: Toxin-Induced Causes of a Normal Anion Gap Metabolic Acidosis

Keywords: anion gap, metabolic acidosis (PubMed Search)

Posted: 12/8/2010 by Bryan Hayes, PharmD (Emailed: 12/9/2010) (Updated: 12/9/2010)
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Most cases of normal anion gap metabolic acidosis result from either urinary (RTA) or gastrointestinal HCO3- losses (diarrhea).  A number of xenobiotics can also cause this disorder:

  1. Acetazolamide
  2. Acidifying Agents: Ammonium chloride, arginine hydrochloride, hydrochloric acid, lysine hydrochloride
  3. Cholestyramine
  4. Toluene
  5. Topiramate (Topamax)