Hypokalemia caffeine

Un, acute exacerbation of chronic bronchitis prophylaxis in transurethral procedures Action Quinolone antibiotic -1- DNA gyrase. Dose 400 mg/d PO X w/ renal insuff, avoid antacids Caution [C, —] Interactions w/ cation-containing products Contra Quinolone all gy, children <18 y,T QT interval, X Disp Tabs SE NA/ /D, abd pain, photosens, Szs, HA, dizziness, tendon rupture, periph al neuropathy, pseudomembranous cohtis, anaphylaxis Interactions t Effects W/ cimetidine, probenecid T effects OF cyclosporine, warfarin, caffeine X effects W/ antacids EMS Monitor ECG for TqT int val, esp in pts taking class lA/III antiarrhythmics monitor ECG and BP for signs of h5 povolemia and electrol5rte disturbances (hypokalemia) d/t D T risk of photosensitivity Rxns OD May cause NA /D, confusion and Szs symptomatic and supportive... 

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. 

Hypokalemia and myopathy are known effects of caffeine toxicity, and severe hjrpokalemia and fatigue and hypokalemia with myopathy have been described before (19). 

Caffeine toxicity is an uncommon cause of myopathy, but a history of excessive dietary and pharmaceutical consumption of caffeine should be sought in any patient with unexplained myopathy, particularly if there is concomitant hypokalemia (28). 

A. The earliest symptoms of acute caffeine poisoning are usually anorexia, tremor, and restlessness. These are followed by nausea, vomiting, tachycardia, and confusion. With serious intoxication, delirium, seizures, supraventricular and ventricular tachyarrhythmias, hypokalemia, and hyperglycemia may occur. Hypotension is caused by excessive beta-2-mediated vasodilation and is characterized by a low diastolic pressure and a wide pulse pressure. 

IV. Diagnosis is suggested by the history of caffeine exposure or the constellation of nausea, vomiting, tremor, tachycardia, seizures, and hypokalemia (also consider theophylline see p 354). 

Tolerance to the diuretic action of caffeine was demonstrated more than 50 years ago and was shown to develop on chronic caffeine intake so that the clinical significance of hypokalemia and calciuria is difficult to evaluate. Although controversial, some epidemiological studies have implicated caffeine in the increased risk for poor calcium retention. For calcium intakes lower than 750 mg per day, increased rate of bone loss and lower bone density were reported. However, it has been suggested that the effect on bone of high caffeine intake requires a genetic predisposition toward osteoporosis. In individuals who ingest calcium recommended daily allowances, there is no evidence of any effect of caffeine on bone status and calcium economy. 

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