Emergency Management and Commonly Encountered Outpatient Scenarios in Patients With Hyperkalemia

Sood, Manish M.; Sood, Amy R.; Richardson, Robert

doi:10.1016/s0025-6196(11)61102-6

Cited by 54 publications

(49 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Distal tubule urine flow may influence potassium secretion because increased flow increases the concentration gradient and therefore, potassium loss. As renal function declines, a greater fraction of the filtered load is excreted, and plasma potassium levels generally do not rise until renal function declines to less than 25% of normal [1][2][3].…”

Section: Normal Potassium Homeostasismentioning

confidence: 99%

Electrocardiogram manifestations in hyperkalemia

Cohen¹,

Ramos²,

Garcia³

et al. 2012

WJCD

View full text Add to dashboard Cite

Hyperkalemia is defined as serum potassium level of more than 5 mmol/L. Prompt identification of hyperkalemia and appropriate management are critical, since severe hyperkalemia can lead to lethal cardiac dysrhythmias. There is a wide range of electrocardiogram (EKG) changes associated with hyperkalemia. The sequence of EKG changes has been previously described with limited information to correlate the level of potassium to a particular change in the EKG. This study aims to describe a correlation between the level of potassium and EKG changes in the presence or absence of certain diagnoses, to determine which EKG finding in the context of level of hyperkalemia, should be considered life-threatening and prompt emergency intervention. If a relationship between serum levels of potassium and EKG changes is significant, clinicians may be able to better monitor and treat hyperkalemic patients. This paper reviews the literature on hyperkalemia, potassium homeostasis and EKG changes attributed to elevated potassium.

show abstract

Section: Normal Potassium Homeostasismentioning

confidence: 99%

Electrocardiogram manifestations in hyperkalemia

Cohen¹,

Ramos²,

Garcia³

et al. 2012

WJCD

View full text Add to dashboard Cite

show abstract

“…10,11 This is important because sudden death in patients taking spironolactone may erroneously be attributed to intrinsic heart disease.…”

mentioning

confidence: 99%

“…9 However, we did not examine whether the drug interaction was associated with an increased risk of sudden cardiac death, a predictable consequence of severe hyperkalemia. 10,11 This is important because sudden death in patients taking spironolactone may erroneously be attributed to intrinsic heart disease.…”

mentioning

confidence: 99%

Trimethoprim–sulfamethoxazole and risk of sudden death among patients taking spironolactone

Antoniou

Hollands

Macdonald

et al. 2015

CMAJ

View full text Add to dashboard Cite

T he use of spironolactone increased considerably following publication of the Randomized Aldactone Evaluation Study, which showed that the drug improved morbidity and mortality in carefully selected patients with severe systolic heart failure.1,2 Although spironolactone is generally well tolerated, hyperkalemia is a potentially life-threatening adverse effect of the drug in clinical practice.3-5 Strategies for mitigating the risk of serious hyperkalemia include cautious dosing of spironolactone, close monitoring of electrolyte levels and avoidance of other drugs that cause hyperkalemia.The widely used antibiotic trimethoprim has pharmacologic similarities to the potassium-sparing diuretic amiloride. It reduces urinary potassium excretion by about 40% and can increase the risk of life-threatening hyperkalemia in susceptible individuals, including those taking spironolactone.6,7 In combination with sulfamethoxazole, trimethoprim is most often used for the treatment of urinary tract infections. More than 20 million prescriptions are written for the combination each year in the United States. 8 We have previously shown that the use of trimethoprim-sulfamethoxazole in patients receiving spironolactone increased the risk of hospital admission with hyperkalemia more than 12-fold relative to amoxicillin.9 However, we did not examine whether the drug interaction was associated with an increased risk of sudden cardiac death, a predictable consequence of severe hyperkalemia. 10,11 This is important because sudden death in patients taking spironolactone may erroneously be attributed to intrinsic heart disease.Because treatment with trimethoprimsulfamethoxazole can precipitate life-threatening hyperkalemia in patients receiving spironolactone, we conducted a study to determine whether

show abstract

“…Inhalation of 10 mg of nebulized salbutamol was reported to induce a short term(about one minute) increase of hyperkalemia 0.15 mEq/L followed in 3-5 min by a decline ranging from 0.4 to 1.5 mEq/l and lasting up to 2-4 h, after which the level steadily increases to the original plasma potassium value [41][42][43] . However, up to one third of patients with hyperkalemia do not respond to this therapy.…”

Section: Treatment Of Hyperkalemiamentioning

confidence: 99%

Arrhythmias and ECG changes in life threatening hyperkalemia in older patients treated by potassium sparing drugs

Berková¹,

Berka²,

Topinková³

2014

BIOMED PAP

View full text Add to dashboard Cite

Background. Severe hyperkalemia is a life threatening condition that can cause fatal rhythm disturbance and terminal heart arrest. The most common cause of hyperkalemia in older patients is that of iatrogenic medication-related etiology due to associated polymorbidity, polypharmacy and reduced reserve metabolic capacity. The aim of this paper is to increase awareness in the clinicians of the risk of hyperkalemia in elderly patients treated by potassium sparing drugs. Methods and Results. We present two case reports of hyperkalemia ≥ 9.0 mmol/L induced by potassium sparing medications with cardiac arrhythmias and severe ECG changes including atrial asystole, disturbance of intraventricular conduction and morphological changes such as tenting T waves and deformed wide QRS complexes. The most frequent causes of hyperkalemia in elderly patients are discussed and electrocardiogram changes and arrhythmias in hyperkalemia are analyzed, as well as their treatment and prevention. Conclusion. Potassium sparing drug therapy in older persons requires more frequent monitoring especially when drugs or their doses are changed, or during concomitant acute illness.

show abstract

Emergency Management and Commonly Encountered Outpatient Scenarios in Patients With Hyperkalemia

Cited by 54 publications

References 39 publications

Electrocardiogram manifestations in hyperkalemia

Electrocardiogram manifestations in hyperkalemia

Trimethoprim–sulfamethoxazole and risk of sudden death among patients taking spironolactone

Arrhythmias and ECG changes in life threatening hyperkalemia in older patients treated by potassium sparing drugs

Contact Info

Product

Resources

About