See also [[:wikitox:3.2.1.1.1_acidosis_teaching_resources|Acidosis Teaching Resources]]

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====== Anion Gap Acidosis ======

The anion gap (in mmol/L) = (Na+ K) - (HCO3 + Cl)\\
An anion gap of 7 - 17 mmol/L is normal.

An anion gap > 17 mmol/L, in the presence of acidosis suggests:

  * lactic acidosis - may be secondary to [[:wikitox:3.2.1.1.6_hypotension_and_bradycardia|shock]] or [[:wikitox:3.4.2_control_of_seizures_anticonvulsants|seizures]] from a number of poisons
  * diabetic, alcoholic or starvation ketoacidosis
  * renal failure (GFR < 10% of normal)
  * infantile organic acidosis

or poisoning with one of the following toxins that alter metabolism leading to acidosis:

  * Benzyl alcohol
  * Beta-adrenergic agents
  * Caffeine
  * [[:wikitox:2.2.9.1.1_carbon_monoxide|Carbon monoxide]]
  * [[:wikitox:2.2.9.1.2_cyanide|Cyanide]]
  * [[:wikitox:2.1.11.5.1_acute_management_of_alcohol_problems|Ethanol]]
  * [[:wikitox:2.2.5.2.2_ethylene_glycol|Ethylene glycol]]
  * Hydrogen sulfide
  * [[:wikitox:2.1.1.2_nonsteroidal_anti_inflammatory_drugs|Ibuprofen]]
  * [[:wikitox:2.1.9.6_iron|Iron]]
  * Isoniazid (INH)
  * [[:wikitox:2.1.11.9.4_mood_stabilizers|Lithium]]
  * [[:biguanide_toxicity|Metformin]]
  * [[:wikitox:2.2.5.2.5_methanol|Methanol]]
  * [[:wikitox:2.1.1.1_acetaminophen|Paracetamol]]
  * Paraldehyde
  * [[:biguanide_toxicity|Phenformin]]
  * [[:wikitox:2.1.1.4_salicylates|Salicylates]]
  * Strychnine
  * [[:wikitox:3.2.1.3_toxidromes|Sympathomimetic amines]]
  * Toluene