Hyperkalaemia

Question 1

Which common drug can cause hyperkalaemia, how does it do so, and what kind of drug is it?

Answer 1

Spironolactone

• aldosterone antagonist
• increases serum potassium

Question 2

When should spironolactone be stopped?

Answer 2

In renal failure, particularly where potassium level is raised

Question 3

What kind of drug is amlodipine, and how does it affect serum potassium?

Answer 3

CCB commonly used in hypertension

- doesn’t affect serum potassium

Question 4

What kind of drug is bendroflumethiazide, and how does it affect serum potassium?

Answer 4

Thiazide diuretic

- lowers serum potassium

Question 5

How effective is bendroflumethiazide at reducing blood pressure in renal failure and why shouldn’t it be stopped?

Answer 5

Fairly ineffective

- may be reducing serum potassium so shouldn’t be stopped

Question 6

What kind of drug is furosemide, and how does it affect serum potassium?

Answer 6

Loop diuretic

- lowers serum potassium

Question 7

When should furosemide be stopped?

Answer 7

If patient presents with acute renal failure secondary to hypovolaemia, furosemide should probably be stopped

Question 8

What kind of drug is simvastatin, and how does it affect serum potassium?

Answer 8

Statin

- doesn’t affect serum potassium

Question 9

What 3 things should be checked if patient is hyperkalaemic/eukalaemic but on medication that might cause them to become hyperkalaemia?

Answer 9

• Check potassium isn’t being added to the patient’s fluid prescription
• Check patient is asymptomatic
• Check ECG for changes