Adrenal insufficiency hyperkalemia

Potassium is contraindicated in patients who are at risk for experiencing hyperkalemia, such as those with renal failure, oliguria, or azotemia (file presence of nitrogen-containing compounds in the blood), anuria, severe hemolytic reactions, untreated Addison s disease (see Chap. 50), acute dehydration, heat cramps, and any form of hyperkalemia Potassium is used cautiously in patients with renal impairment or adrenal insufficiency, heart disease, metabolic acidosis, or prolonged or severe diarrhea. Concurrent use of potassium with... 

Dehydration, hypovolemia, and hyperkalemia (in primary adrenal insufficiency only)... 

Renal impairment or adrenal insufficiency - Renal impairment or adrenal insufficiency may cause potassium intoxication. Potassium salts can produce hyperkalemia and cardiac arrest. Potentially fatal hyperkalemia can develop rapidly and be asymptomatic. Use with great caution, if at all. 

Hyperkalemia may occur in renal disease and adrenal insufficiency owing to impairment of normal secretory mechanisms. Metabolic acidosis, in particular diabetic acidosis, and catabolism of cellular protein in starvation or fever cause K+ release from cells. Treatment consists of correction of the acidosis and promotion of cellular uptake of K+ by administration of insulin, which enhances glucose intake. In severe cases, ion exchange resins given orally bind K+ in intestinal secretions. 

Acute Adrenal Insufficiency This hfe-threatening disease is characterized by G1 symptoms (nausea, vomiting, and abdominal pain), dehydration, hyponatremia, hyperkalemia, weakness, lethargy, and hypotension. It usually is associated with disorders of the adrenal rather than the pituitary or hypothalamus, but sometimes follows abrupt withdrawal of glucocorticoids used at high doses or for prolonged periods. 

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