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Spironolactone can cause hyperkalemia, or high blood potassium levels. [111] Rarely, this can be fatal. [111] Of people with heart disease prescribed typical dosages of spironolactone, 10 to 15% develop some degree of hyperkalemia, and 6% develop severe hyperkalemia. [111] At a higher dosage, a rate of hyperkalemia of 24% has been observed. [119]
[24] [26] It has been determined that 7α-TMS accounts for around 80% of the potassium-sparing effect of spironolactone [1] [2] [3] while canrenone accounts for the remaining approximately 10 to 25%. [4] Accordingly, 7α-TMS occurs at higher circulating concentrations than does canrenone in addition to having a higher relative affinity for the ...
[1] [2] Hyperkalemia can cause an abnormal heart rhythm which can result in cardiac arrest and death. [1] [3] Common causes of hyperkalemia include kidney failure, hypoaldosteronism, and rhabdomyolysis. [1] A number of medications can also cause high blood potassium including spironolactone, NSAIDs, and angiotensin converting enzyme inhibitors. [1]
A more common cause is excessive loss of potassium, often associated with heavy fluid losses that flush potassium out of the body. Typically, this is a consequence of diarrhea, excessive perspiration, losses associated with crush injury, or surgical procedures. Vomiting can also cause hypokalemia, although not much potassium is lost from the ...
Potassium-sparing diuretics or antikaliuretics [1] refer to drugs that cause diuresis without causing potassium loss in the urine. [2] They are typically used as an adjunct in management of hypertension, cirrhosis, and congestive heart failure. [3] The steroidal aldosterone antagonists can also be used for treatment of primary hyperaldosteronism.
Treatment includes removing the causative agent (such as licorice), a high-potassium, low-sodium diet (for primary) and high-sodium diet (for secondary), spironolactone and eplerenone, potassium-sparing diuretics that act as aldosterone antagonists, and surgery, depending on the cause. [11] For adrenal adenoma, sometimes surgery is performed.
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Metabolic alkalosis is an acid-base disorder in which the pH of tissue is elevated beyond the normal range (7.35–7.45). This is the result of decreased hydrogen ion concentration, leading to increased bicarbonate (HCO − 3), or alternatively a direct result of increased bicarbonate concentrations.