Diuretics hypokalemia caused

Diuretics can cause hypokalemia, hyperglycemia, and hypemricemia. After long-term treatment they may increase semm triglyceride and cholesterol... 

Many drugs can cause hypokalemia (Table 78-5) and it is most commonly seen with use of loop and thiazide diuretics. Other causes of hypokalemia include diarrhea, vomiting, and hypomagnesemia. 

Hypertension is often treated with diuretics. Diuretics are drugs that promote the Joss of sodium from the body, though some diuretics can cause the loss of potassium, resulting in hypokalemia. The use of dietary supplements of K to correct this hypokalemia has been shown to be of benefit and to result in decreases in blood pressure. The best source of potassium is plant food, as is strikingly apparent from the data in Table IG.l however, the interest in nonfood supplements of potassium continues. One problem with potassium salts is that they taste bad and can produce nausea. Hence, there has been some interest in the manufacture of aesthetically acceptable forms of potassium salts. One form, a mixture of NaCl and KCl, is useful for those who feel compelled to add sodium chloride to their food. One study revealed that NaCI-KCl mixtures are accepted and their use can result in a reduction of sodium intake. The study, which involved normotensive subjects, did not lead to any consistent change in blood pressure (Mickeisen rt nI., 1977). 

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

Hypokalemia is common in the patient with liver failure who has normal renal function. Poor nutritional intake and vomiting may initiate this disorder. Severe vomiting may lead to volume contraction metabolic alkalosis, with increased renal excretion of potassium. Secondary hyperaldosteronism, seen in the liver failure patient with intravascular depletion, also increases renal excretion of potassium. Loop diuretic therapy causes increased renal excretion of potassium, whereas diarrhea from lactulose therapy increases fecal excretion of potassium. All these conditions can lead to profound hypokalemia. Therefore, potassium requirements in the liver failure patient receiving specialized nutritional support often are increased substantially. 

Answer E. In approaching the answer to this question, try to sort out the incorrect statements. Spironolactone does not cause hypokalemia, but hyperkalemia. Although loop diuretics may cause hyperuricemia, there is no connection between elevations of uric add and fainting episodes. When used with ACEIs in the treatment of heart failure, spironolactone is reported to increase survival, but there is no evidence of similar efficacy in patients with HTN. Obviously, statement B is erroneous (never choose never ). Although postural hypotension from the combination of antihypertensive drugs is most likely responsible for the fainting episode in this patient, there could also be alternative explanations ... 

The use of CA inhibitors as diuretics is limited by their propensity to cause metabolic acidosis and hypokalemia. Their use can be indicated in patients with metabolic alkalosis and secondary hyperaldosteronism resulting for example from aggressive use of loop diuretics. Furthermore, CA inhibitors are effective dtugs to produce a relatively alkaline urine for the treatment of cysteine and uric acid stones as well as for the accelerated excretion of salicylates. Perhaps the most common use of CA inhibitors is in the treatment of glaucoma. 

Hypokalemia is a reduction of plasma K+ concentration below 3.5 mM. Hypokalemia can result from a reduction in dietary K+ intake and from a shift of K into the intracellular space. The most common of hypokalemia, however, is renal K+ loss (i.e., caused by diuretics). 

The answer is c. (Hardman, pp 704-706J Triamterene produces retention of the K ion by inhibiting in the collecting duct the reabsorption of Na, which is accompanied by the excretion of K ions. The loop diuretics furosemide and bumetanide cause as a possible adverse action the development of hypokalemia. In addition, thiazides (e g, hydrochlorothiazide) and the thiazide-related agents (e.g., metolazone) can cause the loss of K ions with the consequences of hypokalemia. Triamterene can be given with a loop diuretic or thiazide to prevent or correct the condition of hypokalemia. 

The activity of the renin-angiotensin system is reduced with age (Muhlberg and Platt 1999). The ability of the kidney to concentrate urine maximally after water deprivation decreases with age, as does the ability to excrete a water and salt load, particularly during the night. Nocturnal polyuria is common in the elderly (Lubran 1995). Diuretics are commonly used in the elderly. There is an increased risk for hypokalemia and hyponatremia from diuretics in the elderly (Passare et al. 2004). Electrolyte disturbances may also be caused by several types of drugs in the elderly and it is important to monitor serum electrolyte levels in the elderly. Treatment with... 

K /Na exchange in distal tubule Dose Adults. 5-10 mg PO daily Peds. 0.625 mg/kg/d X in renal impair Caution [B, ] Contra T K, SCr >1.5 mg/dL, BUN >30 mg/dL, diabetic neuropathy Disp Tabs SE T K HA, dizziness, dehydration, impotence Interactions T Risk of hyperkalemia W/ ACEI, K-sparing diuretics, NSAIDs, K salt substitutes T effects OF Li, digoxin, antihypertensives, amantadine T risk of hypokalemia W/ licorice EMS Monitor ECG for signs of hyperkalemia (peaked T waves) T effects of digoxin OD May cause bradycardia, light-headedness, and syncope symptomatic and supportive... 

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