Metformin is an oral antidiabetic drug of the biguanide classused in type 2 diabetic patients with normal renal function. The mortality rate is high in cases of lactic acidos is developing in metformin intoxication. In the emergency department, metformin intoxication should be considered in the differential diagnosis of patients whouse metformin and have high anion gap metabolic acidosis (lactic acidosis). The most important and effective treatment with early diagnosis is correction of metabolic acidosis with hemodialysis or hemofiltration methods, bicarbonate treatment, adjustment of blood glucose level. Cardiovascular system support therapy significantly reduces morbidity/mortality. In this case report, we present the early diagnosis and successful treatment of a patient with lactic acidosis due to metformin intoxication.

Cases of intoxication are among the common medical emergencies. Cases of suicidal drug intoxication are more common among young people. Based on this information, our study aimed to identify the demographic and etiological characteristics of cases of drug intoxication and their costs to the social security institution. The files of patients diagnosed with drug intoxication in the adult emergency department of Kahramanmaraş Sutcu Imam University Medical Faculty Hospital between 01.01.2022 and 31.12.2022 were reviewed retrospectively from the automation system. In our study, the data of 110 patients admitted to the emergency department with a clinical picture of drug-related intoxication were evaluated. 75.5% of the patients were female and 40% of them were in the 18-24 age group. It was determined that 92.7% of the patients took the drug that caused intoxication for suicidal purposes and that psychiatric agents constituted a significant part of the drugs taken. Treatment costs increased significantly in cases of suicidal drug intake and multiple drug intake. The length of hospital stay and the cost of treatment increased as the time between the time of drug intake and the hospital arrival time increased. Most of the drug-related intoxications occurred due to suicidal intake. Most of the drugs used for this purpose were analgesics and psychiatric drugs. Emergency departments are the first places where patients with drug intoxication are evaluated, and all physicians working in the emergency department should know the approach to intoxication very well.

The blurring of consciousness is one of the common causes of admission to emergency departments. While evaluating an unconscious patient, all system examinations should be done more carefully and thoroughly since the unconscious patients cannot express themself adequately a patient with non-traumatic hemorrhagic cerebrovascular accident & spontaneous pneumothorax is a rare condition. In this case we aim to present, life-threatening severe clinical conditions could be occur, if the intervention is delayed.