Lactic acidosis is not seen in
Answer is D (Tolbutamide) : Oral hypoglycemics of the biguanide group (Metformin & Phettfelrmin) are known to cause Lactic acidosis. It is not a complication of sulfonylureas such as Tolbutamide, Chlorpropamide etc. Lactic acidosis Lactic acid is produced from pyruvate when oxidative metabolism is reduced and glycolysis is increased. Lactic acidosis occurs when the rate of production of lactic acid from pyruvate in muscle, skin brain and erythrocytes exceeds the rate of removal by liver and kidney. The ingestion of methanol (wood alcohol) causes metabolic acidosis and its metabolites formaldehyde and formic acid cause severe optic nerve and central nervous system damage. Lactic acide, Aceto-acids and other unidentified organic acids contribute to the acidosis.
Methanol poisoning
Respiratory failure
Circulatory failure
Tolbutamide