Q: How intravenous (IV) epinephrine generates lactic acidosis?
Answer: IV epinephrine essentially leads to lactic acidosis by three mechanisms
1. increase glycolysis in skeletal muscle
2. hypoperfusion of the gastrointestinal (GI) tract
3. reduce hepatic lactate uptake.
Side note: This is the same mechanism by which lactic acidosis is produced in pheochromocytoma.
#pharmacology
#acid-base
References:
1. Day NP, Phu NH, Bethell DP, et al. The effects of dopamine and adrenaline infusions on acid-base balance and systemic haemodynamics in severe infection. Lancet 1996; 348:219.
2. Madias NE, Goorno WE, Herson S. Severe lactic acidosis as a presenting feature of pheochromocytoma. Am J Kidney Dis 1987; 10:250.
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