Nafcillin-Associated Hypokalemia

Parthvi, Rukma; Amin, Mohsena; Sunil, Mehra

doi:10.1097/mjt.0000000000000760

Cited by 3 publications

(6 citation statements)

References 2 publications

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“…The reviewed literature suggested that drug-induced hypokalemia rarely occurs after starting therapy with penicillin-type antimicrobials, such as nafcillin [1,3,6,7,8], with the baseline potassium level being a key determinant in the development of hypokalemia [7]. Patients with a higher baseline potassium level had a lesser likelihood of developing severe hypokalemia but had a higher likelihood of having an acute drop in the potassium level [7].…”

Section: Discussionmentioning

confidence: 99%

“…Although this patient’s baseline potassium was around 4.3 meq/L, there was an acute drop in his potassium levels to less than 3.5 meq/L once nafcillin was started. With nafcillin, induced hypokalemia is related to non-absorbable ion effects in the distal tubule and/or intracellular redistribution due to volume depletion [6,7,8]. Sodium is presented to the distal nephron with a relatively large quantity of non-absorbable anions, which leads to increased sodium reabsorption.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…When nafcillin-associated hypokalemia is identified, aggressive potassium replacement is indicated to correct the hypokalemia [8]. The problem may also be corrected by merely decreasing the dose of nafcillin [8,11]. However, if a higher dose of the antibiotic is indicated, a potassium-sparing agent (such as spironolactone or eplerenone) may be concurrently used [8], but this was not initiated in this patient because his hypokalemia improved with potassium supplements.…”

Section: Discussionmentioning

confidence: 99%

“…Less common causes are renal tubular acidosis, diabetic ketoacidosis, excess insulin, primary hyperaldosteronism, ectopic adrenocorticotropic hormone production, and medications [2,3,4,5,6]. Drug-induced hypokalemia rarely occurs after starting therapy with penicillin-type antimicrobials, such as nafcillin [1,3,6,7,8].…”

Section: Introductionmentioning

confidence: 99%

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A Case of Hypokalemia Possibly Induced by Nafcillin

Gutiérrez

Mudunuru

Nasr³

2018

Antibiotics

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(1) Background: The use of intravenous antibiotics for severe infections is a common practice, either as inpatient or outpatient treatment. In the case of methicillin-susceptible Staphylococcus aureus (MSSA), nafcillin is a commonly prescribed intravenous antibiotic, given its known efficacy to treat infections related to this organism effectively. However, it is not without side effects. (2) Methods: We present an interesting case of persistent hypokalemia in a patient after he was started on nafcillin infusion for an MSSA infection, which eventually resolved with the completion of the treatment. (3) Results: Hypokalemia is a known side effect of nafcillin infusion, and it is believed to be mainly due to its antibiotic effect as a non-absorbable ion in the distal tubule and/or intracellular redistribution due to volume depletion. (4) Conclusions: A review of the available literature revealed that hypokalemia is a known side effect of nafcillin infusion; however, if present, it is usually mild, and only a few cases of severe hypokalemia have been reported. Usually, hypokalemia resolves when the nafcillin infusion is stopped; however, in certain cases, when this is not possible, oral potassium replacement can be used while the patient is receiving nafcillin. Clinicians should be aware of this rare, but possible, complication when using nafcillin.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A Case of Hypokalemia Possibly Induced by Nafcillin

Gutiérrez

Mudunuru

Nasr³

2018

Antibiotics

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Nafcillin

2019

Reactions Weekly

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Nafcillin-Associated Hypokalemia

이도현¹,

이은경²,

김소미³

et al. 2021

Korean J Med

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Hypokalemia is a common finding in various clinical settings; it is associated with diuretic use and loss of potassium via the gastrointestinal tract. Less common causes are renal tubular acidosis, diabetic ketoacidosis, excess insulin, primary hyperaldosteronism, and medications, such as amphotericin B. Nafcillin, a narrow-spectrum penicillin class antibiotic, which is selectively prescribed for methicillin-susceptible Staphylococcal aureus infections, and is commonly associated with gastrointestinal side effects, such as nausea, vomiting, and abdominal pain. However, in rare cases it can cause hypokalemia, which is usually overlooked. Severe hypokalemia was detected in a 59-year-old male patient hospitalized due to traumatic cerebral hemorrhage who received 12 g of nafcillin per day for more than 2 weeks for sepsis caused by methicillin-sensitive <i>Staphylococcus epidermidis</i>. We confirmed the association between nafcillin and hypokalemia through further evaluation and a review of the relevant literature. Clinicians should be aware of hypokalemia as a complication when using high doses of nafcillin.

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Nafcillin-Associated Hypokalemia

Cited by 3 publications

References 2 publications

A Case of Hypokalemia Possibly Induced by Nafcillin

A Case of Hypokalemia Possibly Induced by Nafcillin

Nafcillin

Nafcillin-Associated Hypokalemia

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