Hypochloremia metabolic alkalosis

The effects of these drugs are practically identical. This group of drugs is characterized by three main side effects (1) hyperuricemia, (2) hyperglycemia, and (3) irregular elecffolytic balance that can be characterized by hypercalcemia, hypochloremia, and metabolic alkalosis. 

Electrolyte imbalance and BUN increases Hyponatremia and hypochloremia may occur when amiloride is used with other diuretics. Increases in BUN levels usually accompany vigorous fluid elimination, especially when diuretic therapy is used in seriously ill patients, such as those who have hepatic cirrhosis with ascites and metabolic alkalosis, or those with resistant edema. 

Hjqiochloremia is common in gastrointestinal disease (Svendsen et al 1979), because of the loss of gastric hydrochloric acid in high volume reflux from the stomach (in proximal enteritis and grass sickness) and the secretion and/or lack of absorption of chloride in severe colitis. It may also occur in exhausted horse syndrome, chronic compensated respiratory acidosis and following furosemide (frusemide) administration. Hypochloremia in the absence of hyponatremia results in a metabolic alkalosis (Corley Marr 1998). The alkalosis associated with hypochloremia may also result in increased cellular uptake of potassium, leading to hypokalemia (Schaer 1999). 

Loss of gastric acid from vomiting or nasogastric suction- ing is often responsible for the development of a metabolic alkalosis, characterized by hypochloremia and hyperbicar-bonatemia. 

Changes in plasma chloride are generally paralleled by changes in plasma sodium and often show an inverse relationship to plasma bicarbonate. Hypochloridemia (or hypochloremia) is observed in conditions of severe dehydration, gastrointestinal fluid loss, and metabolic alkalosis. Hyperchloremia is associated with metabolic acidosis or respiratory alkalosis. 

Loop or high-ceiling diuretics causes a vasodilatory effect and increase renal blood flow before diuresis. The most common side effects are fluid and electrolyte imbalances such as hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia, and hypochloremia. Hypochloremic metabolic alkalosis may result. Orthostatic hypotension can also occur. Thrombocytopenia, skin disturbances, and transient deafness are seen rarely. Prolonged use can cause thiamine deficiency. 

Auestad et al., 2003). In 1978 and 1979, two soy-based formulas were released that contained markedly decreased chloride content. The result was a large number of cases of what was termed the chloride deficiency syndrome diagnosed between 1 and 6 months of age (Roy, 1984). These infants presented with failure to thrive, lethargy, muscular weakness, and loss of appetite. Laboratory analysis revealed metabolic alkalosis, hypochloremia, hypokalemia, and hyponatremia. Nine- and 10-year follow-up of some of these infants showed no measurable deficits in cognitive development (Willoughby et al., 1990). 

---