High Anion Gap Metabolic Acidosis (HAGMA) - Mnemonics

Why should we switch from MUDPILES to GOLDMARK?

 • Metabolic acidosis due to excessive paraldehyde or phenformin use has become very rare.

 • Iron and isoniazid are just two of many drugs and toxins that can cause hypotension and lactic acidosis. Isoniazid can also generate a component of ketoacidosis.

 • Three new organic acids and acid precursors have been recognized as causes of AGMA:  1) D-lactate, 2) 5-oxoproline, 3) propylene glycol



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