Hyperkalemia causes

The hypotensive effects of most antihypertensive dru are increased when administered with diuretics and other antihypertensives. Many dnigp can interact with the antihypertensive drugs and decrease their effectiveness (eg, antidepressants, monoamine oxidase inhibitors, antihistamines, and sympathomimetic bronchodilators). When the ACE inhibitors are administered with the NSAIDs, their antihypertensive effect may be decreased. Absorption of the ACE inhibitors may be decreased when administered with the antacids. Administration of potassium-sparing diuretics or potassium supplements concurrently with the ACE inhibitors may cause hyperkalemia. When the angiotensin II receptor agonists are administered with... 

NSAIDs can cause renal insufficiency when administered to patients whose renal function depends on prostaglandins. Patients with chronic renal insufficiency or left ventricular dysfunction, the elderly, and those receiving diuretics or drugs that interfere with the renin-angiotensin system are particularly susceptible. Decreased glomerular filtration also may cause hyperkalemia. NSAIDs rarely cause tubulointerstitial nephropathy and renal papillary necrosis. 

Potassium-sparing diuretics may cause hyperkalemia, especially in patients with chronic kidney disease or diabetes, and in patients receiving concurrent treatment with an ACE inhibitor, ARB, NSAID, or potassium supplement. Eplerenone has an increased risk for hyperkalemia and is contraindicated in patients with impaired renal function or type 2 diabetes with proteinuria. Spironolactone may cause gynecomastia in up to 10% of patients, but this effect occurs rarely with eplerenone. 

Hyperkalemia AmWonde may cause hyperkalemia (serum potassium greater than 5.5 mEq/L) that, if uncorrected, is potentially fatal. Monitor serum potassium carefully. Symptoms of hyperkalemia include paresthesias, muscular weakness, fatigue, flaccid paralysis of the extremities, bradycardia, shock, and EGG abnormalities. 

Which of the following adjuvants to anesthesia has the potential to cause hyperkalemia, postoperative muscle pain, muscle fasciculation, and prolonged apnea and paralysis in genetically sensitive patients ... 

Alterations in the serum potassium level are hazardous because they can result in cardiac arrhythmias. Drugs that may cause hyperkalemia despite normal renal function include potassium itself, 13 blockers, digitalis glycosides, potassiumsparing diuretics, and fluoride. Drugs associated with hypokalemia include barium, 13 agonists, caffeine, theophylline, and thiazide and loop diuretics. 

Hypertension is a common occurrence with tacrolimus and may require treatment with antihypertensive agents. Since tacrolimus may cause hyperkalemia, potassium-sparing diuretics should be avoided... 

As a potassium-sparing diuretic, amiloride can cause hyperkalemia (3), even in patients who are taking a potassium-wasting diuretic (4). This effect can be enhanced by concomitant therapy with ACE inhibitors or angioten-sin-II receptor antagonists. In five patients with diabetes melUtus over 50 years of age who were taking an ACE inhibitor the serum potassium rose markedly 8-18 days after the addition of amiloride (5). AH but one had some degree of renal impairment In four cases potassium concentrations were between 9.4 and 11 mmol/1. 

The authors suggested that the structural similarity between aminocaproic acid and lysine and arginine underlies the mechanism of hjrperkalemia intravenous arginine can cause hyperkalemia (66,67). Furthermore, aminocaproic acid infusion in anephric dogs caused a rapid rise in serum potassium (68). 

Infusion of amphotericin deoxycholate can cause hyperkalemia, in particular in the setting of renal insufficiency (67). The primary mechanism is not known. 

ACE inhibitors can cause hyperkalemia because they inhibit the release of aldosterone. The effect is usually not significant in patients with normal renal function. However, in patients with impaired kidney function and/or in patients taking potassium supplements (including salt substitutes) or potassium-sparing diuretics, and especially aldosterone antagonists, hyperkalemia can occur. In two cases, hypoaldosteronism with diabetes was implicated (53,54). 

Potassium-wasting diuretics can cause sodium and potassium depletion with hyponatremia and hypokalemia. Potassium-retaining diuretics can cause hyperkalemia. 

The juice of M. citrifolia has been reported to cause hyperkalemia (5). 

Although co-trimoxazole in therapeutic doses can cause hyperkalemia (52), it is thought to be caused by the potassium-sparing effects of trimethoprim (53). 

Note in addition to the conditions listed, any cause of adrenal or renal failure, rhabdomyolysis, or hemolytic anemia may cause hyperkalemia. 

Dyazide) < 30 mL/min) may cause hyperkalemia, especially in combination with an ACE inhibitor, angiotensin-receptor blocker, or potassium supplements... 

In addition to CKD as a risk factor, other contributing factors should also be considered. This includes exposure to potassium-sparing diuretics -blockers, which work predominantly via 82-antagonistic effects to interfere with the extrarenal translocation of potassium into cells and ACEls, which may cause hyperkalemia by reducing aldosterone production. Polycitra, used for the treatment of metabolic acidosis, contains potassium citrate and should not be prescribed for patients with severe CKD. If hyperkalemia develops, management options are based on the degree to which potassium is elevated (see Chap. 50). 

Answer D. Drugs that decrease extracellular potassium such as the thiazide and loop diuretics and adrenal glucocorticoids will lead to an increased requirement for insulin by making it more difficult to release the hormone from the B cells of the pancreas. Spironolactone is K sparing, tends to cause hyperkalemia, and does not interfere with the release of insulin. Stress conditions such as examinations also increase insulin requirement. 

Amiloride is used with thiazide or loop diuretics in hypertension, in congestive heart failure, in digitalis-induced hypokalemia, and in arrhythmias resulting from hypokalemia. Inappropriate use of amiloride may cause hyperkalemia (potassium >5.5 mEq/L), which may be fatal if not corrected, and may be more deleterious in elderly individuals and in patients with diabetes mellitus and renal impairment. The symptoms of hyperkalemia include fatigue, flaccid paralysis of the extremities, paresthesias, bradycardia, ECG abnormalities, and shock. Amiloride is not metabolized but is contraindicated in anuria, acute or chronic renal insufficiency, or in diabetic nephropathy. It should not be used with potassium preparations, and should be used cautiously with ACE inhibitors because these agents cause hyperkalemia. 

Release from leukocytes and platelets Tissue injury during blood collection Delayed sample separation Use of potassium EDTA salts as anticoagulants Example compounds causing hyperkalemia ... 

Hyperkalemia Despite some reduction in the concentration of aldosterone, significant K+ retention is rarely encountered in patients with normal renal function who are not taking other drugs that cause retention. However, ACE inhibitors may cause hyperkalemia in patients with renal insufficiency or in patients taking K+-sparing diuretics, K+ supplements, adrenergic receptor antagonists, or NSAIDs. 

Which one of the following dmgs has caused hyperkalemia leading to cardiac arrest in patients with neurologic disorders ... 

Serum potassium Myocardial function is critically dependent on serum potassium level. Drugs that cause hyperkalemia include beta-adrenoceptor blockers, digitalis (in suicidal overdose), fiuoride, and lithium. Drugs associated with hypokalemia include barium, beta-adrenoceptor agonists, methylxanthines, most diuretics, and toluene. 

---