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Drug-Induced Hypokalemia
Drug Induced Hypokalaemia

Presentation

We describe a case of ATIN and Fanconi syndrome presenting as hypokalemic paralysis in a patient receiving rifampin. Case presentation A 42-year-old man was hospitalized with sudden-onset weakness in both lower extremities. [bmcnephrol.biomedcentral.com]

Patient 3 A 45-year-old woman, with a remote history of intravenous drug use, presented after 7 days of lethargy and anorexia. [mja.com.au]

At presentation, he had ingested 8 mg of licorice daily for the previous 17 days. The patient presented with severe hypokalemia (1.8 mEq/L) and rhabdomyolysis. His renin activity was 0.44 ng/mL/h, and his aldosterone level was 6.0 pg/mL. [ekjm.org]

Case Presentation A 69-year-old African-American man presented with a 1-month history of progressive generalized weakness, fatigue and anorexia. The patient denied a history of constipation, polyuria or polydipsia, nausea or vomiting. [karger.com]

Neurologic

  • Paresthesia

    Cardiac arrhythmia Cardiac arrest Ileus Rhabdomyolysis Possibly asymptomatic if hypokalemia is mild Muscle weakness, cramps Paresthesia Abdominal cramps Anorexia Nausea, vomiting Constipation Polyuria, nocturia Excessive thirst Fatigue Palpitations Assessment-Physical [quizlet.com]

    […] combination with an aminoglycoside than as a monotherapy. [5] Other adverse effects include hypersensitivity reactions, hepatotoxicity, neurotoxicity, delirium, bleeding manifestations, electrolyte and acid-base disorders, neutropenia and thrombocytopenia, paresthesia [ijp-online.com]

    HISTORY AND PHYSICAL EXAMINATION Severe hyperkalemia (more than 6.5 mEq per L [6.5 mmol per L]) can cause muscle weakness, ascending paralysis, heart palpitations, and paresthesias. [aafp.org]

Urogenital

  • Polyuria

    A vasopressin-resistant polyuria and urinary acidification and concentration defects are the principal renal manifestations. [jamanetwork.com]

    During the first 24 hours of hospital stay, polyuria (urine output > 6 L/d) with minimal colostomy loss was noted. [jpgmonline.com]

    The administration of both has been shown to cause a metabolic alkalosis and hypokalemia with polyuria. [karger.com]

    Potassium may be lost via urine because of: Diuretic drugs like loop diuretics and thiazide diuretics Polyuria (kidney disorder causing excessive urination) A deficiency of magnesium in the blood (a common side effect of alcohol withdrawal) Excessive [curejoy.com]

    Cardiac arrhythmia Cardiac arrest Ileus Rhabdomyolysis Possibly asymptomatic if hypokalemia is mild Muscle weakness, cramps Paresthesia Abdominal cramps Anorexia Nausea, vomiting Constipation Polyuria, nocturia Excessive thirst Fatigue Palpitations Assessment-Physical [quizlet.com]

Workup

The workup to elucidate the etiology of his hypercalcemia revealed his intact PTH level to be appropriately suppressed to 0.95 pmol/l (normal range: 1.06-6.9 pmol/l) and his PTH-related peptide level to be 27 ng/l (normal range: 14-27 ng/l). 25-hydroxy [karger.com]

Cardiac evaluations using serial ECGs with measurements of the QTc interval are essential and should be performed on all patients undergoing workup for periodic paralysis. 23, 24, 25 References 1. [hkpp.org]

[…] more practical approach is calculation of the urine potassium-to-creatinine ratio from a spot urine specimen; a ratio greater than 1.5 mEq per mmol (13 mEq per g) is indicative of renal potassium wasting. 18 If no cause is identified with the initial workup [aafp.org]

Treatment

Thoroughly covers hot topics in this fast-changing field, including ongoing clinical research and changing treatment protocols. [books.google.de]

Treatment of acute hyperkalaemia in adults. March 1, 2014. http://www.renal.org/guidelines/joint-guidelines/treatment-of-acute-hyperkalaemia-in-adults#sthash.o9MgdJbw.dpbs. Accessed September 1, 2014. 31. Smellie WS. Spurious hyperkalaemia. [aafp.org]

Treatment of hyperkalemia also includes treatment of any underlying causes (for example, kidney disease, adrenal disease, tissue destruction) of hyperkalemia. [medicinenet.com]

Hypertension Initial treatment —In the sixth report of the Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI), a varied selection of antihypertensive agents is recommended for the initial treatment of [drugs.com]

Etiology

The workup to elucidate the etiology of his hypercalcemia revealed his intact PTH level to be appropriately suppressed to 0.95 pmol/l (normal range: 1.06-6.9 pmol/l) and his PTH-related peptide level to be 27 ng/l (normal range: 14-27 ng/l). 25-hydroxy [karger.com]

[…] as with ongoing diuretic therapy or hyperaldosteronism, 20 mmol per day is usually sufficient. 15 Causes of Hyperkalemia Hyperkalemia is caused by excess potassium intake, impaired potassium excretion, or transcellular shifts ( Table 2 ). 8, 24 The etiology [aafp.org]

Pathophysiology

Profound potassium depletion may also cause muscle vacuolation and rhabdomyolysis, and renal tubular vacuolation.1 The pathophysiologic events [jamanetwork.com]

Well organized and highly readable, it covers every relevant topic in the field, from anatomy, physiology, and pathophysiology, to diagnosis and management of kidney disease, to fluid and electrolyte disorders, hypertension, dialysis, and renal transplantation [books.google.de]

The results of these studies may have important physiological and pathophysiological implications inasmuch as the results obtained could suggest a mechanistic link between cardiac diseases (substrate), hypokalemia (trigger), and TdP tachyarrhythmias. [circ.ahajournals.org]

The pathophysiology of common causes of syncope. Postgrad Med J. 2000; 76 (902): 750-3 5. Yealy DM, Delbridge TR. Rosen's Emergency Medicine: Concepts and Clinical Practice. 2010; 6. Dubin D. [traumamon.com]

Riccardi D, Brown EM: Physiology and pathophysiology of the calcium-sensing receptor in the kidney. Am J Physiol Renal Physiol 2010;298:F485-F499. [karger.com]

Prevention

Prevention and Treatment of Diuretic Induced Hypokalemia The first approach to preventing diuretic-induced hypokalemia is to use the lowest dose possible (Table 1). [barnardhealth.us]

Now in its second edition, this popular and essential comprehensive resource provides a detailed analysis of how to identify, prevent, and manage drug-induced diseases. Edited by James E. Tisdale and Douglas A. [books.google.de]

In normal individuals, healthy kidneys can adapt to excessive oral intake of potassium by increasing urine excretion of potassium, thus preventing the development of hyperkalemia. [medicinenet.com]

To prevent cardiac conduction disturbances, intravenous calcium is administered to patients with hyperkalemic electrocardiography changes. [aafp.org]

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