Drug-Induced Hypokalemia FREE

RUSSELL W. CHESNEY, MD

Am J Dis Child. 1976;130(10):1055-1056. doi:10.1001/archpedi.1976.02120110017001.

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ABSTRACT

ABSTRACT | REFERENCES

Although hypokalemia (defined as a low serum potassium concentration) usually reflects total body intracellular potassium depletion, it can exist in the absence of external losses, due either to abrupt shifts in extracellular pH or glucose concentration. Conversely, since only 2% of total body potassium content is extracellular, normal serum values may be seen with significant intracellular depletion. The principal clinical manifestations of potassium depletion are profound skeletal muscle weakness with loss of deep tendon reflexes, smooth muscle weakness resulting in paralytic ileus, mental confusion, and, in the presence of marked metabolic alkalosis, increased peripheral vascular resistance and a heightened susceptibility to cardiac arrythmias.¹ Cardiac glycosides aggravate this arrythmic tendency and may be lethal in the presence of hypokalemia. A vasopressin-resistant polyuria and urinary acidification and concentration defects are the principal renal manifestations. Profound potassium depletion may also cause muscle vacuolation and rhabdomyolysis, and renal tubular vacuolation.1

The pathophysiologic events

REFERENCES

ABSTRACT | REFERENCES

Welt LG, Hollander W Jr, Blythe WB: The consequences of potassium depletion . J Chronic Dis 11:213-254, 1960;.

Katsikas JL, Goldsmith C: Disorders of potassium metabolism . Med Clin North Am 55:503-512, 1971;.

Schultze RG: Recent advances in the physiology and pathophysiology of potassium excretion . Arch Intern Med 131:885-897, 1973;.

O'Regan S, Kaplan BS, Chesney RW, et al: Hypokalemia in childhood leukemia in relapse . Am J Dis Child , to be published.

Hoffbrand BI, Stewart JDM: Carbenicillin and hypokalemia . Br Med J 4:746, 1970;.

Klastersky J, Vanderkelen B, Daneau D, et al: Carbenicillin and hypokalemia . Ann Intern Med 78:774-775, 1973;.

Lipner HI, Ruzany F, Dasgupta M, et al: The behavior of carbenicillin as a nonreabsorbable anion . J Lab Clin Med 86:183-194, 1975;.

Brunner FP, Frick PG: Hypokalemia, massive alkalosis and hypernatremia due to "massive" sodium penicillin therapy . Br Med J 4:550-552, 1968;.

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Fleming BJ, Genuth SM, Gould AB, et al: Laxative-induced hypokalemia, sodium depletion and hyperreninemia: Effects of potassium and sodium replacement on the renin-angiotensin-aldosterone system . Ann Intern Med 83:60-62, 1975;.

Fulop M, Drapkin A: Potassium depletion syndrome secondary to nepropathy apparently caused by "outdated tetracycline." N Engl J Med 272:986-989, 1965;.

Gross EG, Dexter JD, Roth RG: Hypokalemic myopathy with myoglobinuria associated with licorice ingestion . N Engl J Med 274:602-606, 1966;.

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