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1.
Arch. pediatr. Urug ; 92(2): e305, dic. 2021. tab
Article Dans Espagnol | LILACS, BNUY, UY-BNMED | ID: biblio-1278305

Résumé

Las afecciones respiratorias agudas son la primera causa de consulta e ingreso hospitalario en los meses de invierno, y entre ellas el asma ocupa un lugar preponderante. El salbutamol es un broncodilatador con eficacia demostrada en las exacerbaciones y se utiliza de primera línea en el tratamiento. El objetivo de la presente comunicación es analizar dos casos clínicos de niños asmáticos que presentaron efectos adversos al salbutamol y requirieron el ingreso en la Unidad de Terapia Intensiva. Se propone revisar los efectos adversos del salbutamol empleado en crisis asmáticas y analizar las alternativas terapéuticas en esta enfermedad. Los síntomas de los efectos secundarios pueden confundirse con los causados por la propia enfermedad, por lo que puede usarse el fármaco de modo excesivo y es importante conocer el perfil posológico y caracterizar los posibles efectos secundarios en los pacientes para usar de manera racional y segura este medicamento.


Acute respiratory conditions are the first cause of consultation and hospital admission in the Winter months, being asthma the most important. Salbutamol is a bronchodilator with proven efficacy in exacerbations used first-line in treatment. The objective of this paper is to analyze two clinical cases of asthmatic children who presented adverse effects to salbutamol and required admission to the Intensive Care Unit. It is proposed to review the adverse effects of salbutamol used in asthmatic crises and to analyze therapeutic alternatives in this disease. Symptoms of side effects can be confused with those caused by the disease itself, determining the excessive use of this drug, thus, it is important to know the dosage profile and characterize the possible side effects to make rational and safe use of this drug.


As doenças respiratórias agudas são a primeira causa de consultas e internações nos meses de inverno e a asma ocupa é a mais importante. O salbutamol é um broncodilatador com eficácia comprovada nas exacerbações e é usado como tratamento de primeira linha. O objetivo desta comunicação é analisar dois casos clínicos de crianças asmáticas que apresentaram efeitos adversos ao salbutamol e necessitaram de internação em Unidade de Terapia Intensiva. Propõe-se revisar os efeitos adversos do salbutamol utilizado na crise asmática e analisar as alternativas terapêuticas nessa doença. Os sintomas de efeitos colaterais podem ser confundidos com os causados pela própria doença, determinando o uso excessivo desse medicamento, sendo importante conhecer o perfil posológico e caracterizar os possíveis efeitos colaterais nos pacientes para fazer um uso racional e seguro desse medicamento.


Sujets)
Humains , Mâle , Femelle , Enfant d'âge préscolaire , Enfant , Acidose lactique , Bronchodilatateurs/effets indésirables , Salbutamol/effets indésirables , Hyperglycémie/induit chimiquement , Hypokaliémie/induit chimiquement , Agitation psychomotrice/étiologie , Récidive , Asthme/traitement médicamenteux , Tachycardie/induit chimiquement , Tremblement/induit chimiquement , Hallucinations/induit chimiquement
2.
J. bras. nefrol ; 42(2): 250-253, Apr.-June 2020.
Article Dans Anglais, Portugais | LILACS | ID: biblio-1134808

Résumé

ABSTRACT This study reports a case of a 13-year-old male with a 3-year history of severe and intermittent hypokalemia episodes of unknown origin, requiring admission to the intensive care unit (ICU) for long QT syndrome (LQTS), finally diagnosed of redistributive hypokalemia secondary to the abuse of β-adrenergic agonists in the context of a probable factitious disorder.


RESUMO O presente estudo relata o caso de um jovem de 13 anos de idade com histórico, há três anos, de episódios de hipocalemia grave intermitente de origem desconhecida, internado em unidade de terapia intensiva (UTI) por síndrome do QT longo (SQTL). O paciente foi diagnosticado com hipocalemia por redistribuição secundária ao abuso de agonistas β-adrenérgicos, em contexto de provável transtorno factício.


Sujets)
Humains , Mâle , Adolescent , Syndrome du QT long/induit chimiquement , Agonistes bêta-adrénergiques/effets indésirables , Troubles factices/diagnostic , Hypokaliémie/induit chimiquement , Potassium/sang , Potassium/usage thérapeutique , Récidive , Syndrome du QT long/psychologie , Agonistes bêta-adrénergiques/sang , Salbutamol/sang , Mauvais usage des médicaments prescrits/complications , Hypokaliémie/psychologie , Hypokaliémie/sang
3.
Anaesthesia, Pain and Intensive Care. 2017; 21 (1): 90-93
Dans Anglais | IMEMR | ID: emr-187468

Résumé

Rhino-orbito-cerebral mucormycosis is an aggressive and potentially lethal invasive fungal infection. Surgical debridement and amphotericin B remain the mainstay of treatment, however, associated side effects of amphotericin B like nephrotoxicity, hypokalemia, hypertension and arrhythmias need to be addressed. We discuss the anesthetic management of a 47 year old male with uncontrolled diabetes diagnosed with left sinoorbital mucormycosis posted for surgical debridement. The patient received amphotericin B and insulin preoperatively. Nephrotoxicity due to amphotericin B led to hypokalemia in this patient. We also discuss the role of liposomal formulation in preventing hypokalemia and other side effects associated with use of amphotericin


Sujets)
Humains , Mâle , Adulte d'âge moyen , Hypokaliémie/induit chimiquement , Complications du diabète , Infections fongiques du système nerveux central , Maladies du nez , Maladies de l'orbite , Mucormycose
4.
Journal of Forensic Medicine ; (6): 304-306, 2014.
Article Dans Anglais | WPRIM | ID: wpr-983922

Résumé

The combination use of dexamethasone and calcium gluconate can be applied to hypersensitivity. Severe hypokalemia is a usual complication of dexamethasone and calcium gluconate therapy, which occurs frequently with therapeutic use. Fatal cases, accidental and intentional, occur frequently in forensic practice. The current case report presented a 43-year-old man with diabetes mellitus with infection, to whom dexamethasone and calcium gluconate were administered in the private clinic. With the development of such clinical symptoms of severe hypokalemia as quadriplegia, he was confirmed to have severe hypokalemia through a biochemical test before dying of arrhythmia. And also it presented pathophysiologic mechanism underlying severe hypokalemia as well as suggestions for clinical practice regarding combination use of dexamethasone and calcium gluconate.


Sujets)
Adulte , Humains , Mâle , Anti-inflammatoires/effets indésirables , Gluconate de calcium/effets indésirables , Dexaméthasone/effets indésirables , Diabète , Issue fatale , Hypokaliémie/induit chimiquement
5.
Rev. bras. cir. cardiovasc ; 24(3): 367-372, jul.-set. 2009. ilus
Article Dans Portugais | LILACS | ID: lil-533267

Résumé

INTRODUÇÃO: Pacientes após cirurgia cardíaca são comumente tratados com diuréticos para controle de volume plasmático. A preocupação de distúrbios hipocalêmicos em adultos antes, durante ou após a cirurgia já foi ressaltada anteriormente, visto o risco de arritmias cardíacas. Clinicamente, a diluição da solução de potássio (K+) para administração por via intravenosa, em situações que requerem a sua reposição é realizada utilizando-se soro fisiológico (SF) ao invés de soro glicosado 5 por cento (SG5 por cento), possivelmente em vista de poder ocorrer estimulação da secreção de insulina, que interferiria sobre a qualidade da reposição de K+. Porém, não está comprovado experimentalmente se o SF e SG5 por cento poderiam realmente interferir na qualidade da reposição de potássio em ratos com hipocalemia. OBJETIVO: Analisar a influência da reposição de K+ diluído em diferentes veículos sobre as concentrações plasmáticas de K+([K+]p) em ratos submetidos a hipocalemia induzida por furosemida. MÉTODOS: Ratos Wistar adultos foram divididos em quatro grupos: K++SF, K++SG, SF e SG. Foi realizada a canulação da veia jugular para reposição e da veia femoral para coleta de sangue. O diurético furosemida na dose de 50mg/kg foi usado para induzir hipocalemia, foi analisado nível plasmático de potássio 24 h antes da injeção de furosemida, 24 h pós-indução e 30 minutos pós-reposição. RESULTADOS: Os níveis da [K+] pós-injeção de furosemida sofreram redução, comparado aos valores basais (pré-furosemida) em todos os grupos. Entretanto, os níveis [K+] retornaram aos valores basais tanto nos grupos que receberam K++SF ou K++SG, o que não foi observado nos grupos que receberam apenas SF e SG. Quanto ao Na+ plasmático, somente o grupo K+SF apresentou aumento após reposição. CONCLUSÃO: A reposição de K+ diluído tanto em SF quanto SG parece não afetar a qualidade da reposição de K+ plasmático em ratos


INTRODUCTION: Patients who undergo cardiac surgery are commonly treated with diuretic therapy for the management of volume overload. The concern of hypokalemia important in the adult population submitted to cardiac surgery has been described. Intravenous potassium (K+) replacement dilution is only recommended with sodium chloride 0.9 percent solution (SF0.9 percent), likely due to the putative effects of glucose solution 5 percent (SG5 percent) on insulin secretion, which influence K+ replacement quality. However, it is not yet experimentally proved the influence of SF0.9 percent and SG5 percent on K+ replacement quality. Objectives: To evaluate the effects of different vehicles of K+ replacement on blood K+ levels in furosemide hypokalemic rats. METHODS: Male Wistar rats divided into four groups: K+SF, K+SG, SF and SG. Jugular vein cannulation for K+ replacement and femoral vein cannulation for blood analysis. Furosemide (50mg/kg) to induce hypokalemia. We prepared the following solutions: vehicle 1.6mL (SF0.9 percent or SG5 percent) + 0.4 mL de K+ (19.1 percent) and for control groups only vehicle 2 mL. Furosemide (50 mg/kg) was used to induce hypokalaemia, it was analyzed potassium plasmatic levels 24 hours before furosemide injection, 24 hours after furosemide injection and 30 minutes after post-replacement. RESULTS: There was no significative difference in blood K+ levels before furosemide administration, after hypokalemic induction and after K+ replacement among all groups. Only SF+K presented blood Na+ levels increaseafter K+ replacement (P<0.05). CONCLUSION: K+ replacement in different vehicles did not affect blood K+ levels in rats


Sujets)
Animaux , Mâle , Rats , Furosémide/administration et posologie , Glucose/administration et posologie , Hypokaliémie/induit chimiquement , Véhicules pharmaceutiques , Potassium/sang , Chlorure de sodium/administration et posologie , Modèles animaux de maladie humaine , Hypokaliémie/métabolisme , Véhicules pharmaceutiques , Rat Wistar , Facteurs temps
7.
Rev. méd. Chile ; 135(11): 1456-1462, nov. 2007. graf, tab
Article Dans Espagnol | LILACS | ID: lil-472846

Résumé

Hypokalemia (serum K+ < 3.5 mEq/1) is a potentially serious adverse effect of diuretic ingestión. We report a 27 year-old woman admitted with muscle weakness, a serum potassium of 2.0 mEq/1, metabolic alkalosis and EKG abnormalities simulating cardiac ischemia, that reverted with potassium chloride administration. She admitted high dose furosemide self-medication for edema. Glomerular filtration rate, tubular sodium reabsortion, potassium secretion, the renin-aldosterone system, total body water distribution and capillary permeability, were studied sequentially until 90 days after her admission. There was hyperactivity of the renin-aldosterone axis, reduction in extracellular and intracellular volumes, normal capillary permeability and high sodium tubular reabsorption, probably explained by a "rebound" salt retention associated with her decreased extracellular volume.


Sujets)
Adulte , Femelle , Humains , Diurétiques/effets indésirables , Furosémide/effets indésirables , Hypokaliémie/induit chimiquement , Hypovolémie/induit chimiquement , Automédication/effets indésirables , Oedème/traitement médicamenteux , Électrocardiographie/effets des médicaments et des substances chimiques , Chlorure de potassium/usage thérapeutique
8.
Article Dans Anglais | IMSEAR | ID: sea-93781

Résumé

Areflexic quadriplegia due to barium carbonate (rat poison) poisoning is described in two young patients. These cases very closely resembled Guillain-Barre syndrome. The various effects of barium carbonate along with the pathogenesis of hypokalaemic paralysis are highlighted.


Sujets)
Adolescent , Adulte , Baryum/intoxication , Carbonates/intoxication , Diagnostic différentiel , Syndrome de Guillain-Barré/diagnostic , Humains , Hypokaliémie/induit chimiquement , Mâle , Tétraplégie/induit chimiquement , Tentative de suicide
9.
Rev. méd. Chile ; 128(10): 1101-7, oct. 2000. tab
Article Dans Espagnol | LILACS | ID: lil-277202

Résumé

Background: Amphotericin B is efficacious for the treatment of systemic candidiasis, however it has potentially serious toxic effects. Administration as lipid emulsions has been advocated to decrease its toxicity. Aim: To compare the safety and tolerance of amphotericin B administered as lipid emulsion or dissolved in dextrose in water. Patients and methods: Forty five patients with confirmed or highly suspected systemic candidiasis were studied. Between January 1996 and June 1997 amphotericin B was administered in dextrose in water to 17 patients (group 1). Between July 1997 and December 1998, the drug was delivered in lipid emulsions (Intralipid, group 2). Clinical and laboratory parameters (serum creatinine, urea nitrogen and potassium), were assessed daily. Results: Both treatment groups were clinically comparable and had the same survival. Accumulative amphotericin B dose administered was 343.2 ñ 197 and 414.6 ñ 518 mg respectively. Hypokalemia was more frequent in group 2 (52 and 25 percent respectively, p < 0.05). There were no differences in the outcome of renal function or other adverse reactions. Conclusions: Administration of amphotericin B as lipid emulsions did not reduce its toxicity in critical patients


Sujets)
Humains , Femelle , Mâle , Adulte , Adulte d'âge moyen , Candidose/traitement médicamenteux , Amphotéricine B/pharmacologie , Effets secondaires indésirables des médicaments/prévention et contrôle , Candida/isolement et purification , Candida/effets des médicaments et des substances chimiques , Amphotéricine B/administration et posologie , Amphotéricine B/effets indésirables , Tolérance aux médicaments , Hypokaliémie/induit chimiquement , Maladie grave
10.
Rev. méd. Chile ; 127(10): 1223-8, oct. 1999. tab
Article Dans Espagnol | LILACS | ID: lil-255305

Résumé

We report a 72 years old hypertensive female, treated with enalapril 10 mg/day and hydrochlorothiazide 25 mg/day during three years. She presented a depressive disorder and cytalopram was prescribed in a dose of 10 mg/day. Two weeks before admission, a serum electrolyte analysis disclosed normal results and the cytalopram dose was increased to 20 mg/day. The patient was admitted with a hyponatremic encephalopathy with a plasma sodium of 100 mEq/L and a plasma potassium of 2.0 mEq/L. cytalopram, enalapril and hydrochlorothiazide were discontinued, hypertonic NaCl and KCl were administered. The patient had a favorable evolution with a remarkable improvement of her symptoms


Sujets)
Humains , Femelle , Sujet âgé , Hypokaliémie/diagnostic , Hypokaliémie/induit chimiquement , Hypokaliémie/traitement médicamenteux , Hyponatrémie/diagnostic , Hyponatrémie/induit chimiquement , Hyponatrémie/traitement médicamenteux , Chlorure de potassium/usage thérapeutique , Énalapril/effets indésirables , Énalapril/pharmacologie , Chlorure de sodium/usage thérapeutique , Citalopram/effets indésirables , Citalopram/pharmacologie , Trouble dépressif/traitement médicamenteux , Interactions médicamenteuses , Hydrochlorothiazide/effets indésirables , Hydrochlorothiazide/pharmacologie
11.
Alergia inmunol. pediátr ; 5(6): 187-9, nov.-dic. 1996.
Article Dans Espagnol | LILACS | ID: lil-217456

Résumé

El salbutamol es un broncodilatador ß2 agonista utilizado para el tratamiento del asma. La hipokalemia es un efecto secundario que se ha descrito con el uso de salbutamol inhalado aun a dosis terapéuticas habituales. El objetivo del presente estudio fue comparar los niveles séricos de potasio al inicio y después de 60 minutos de la administración de salbutamol inhalado en niños que padecían una crisis asmática. Se realizó un estudio prospectivo, longitudinal, observacional y comparativo de 23 niños con edades entre dos y 16 años, que acudieron al servicio de Urgencia del Instituto Nacional de Pediatría con una crisis asmática. Se les administró salbutamol nebulizado, 1 mg en niños con peso menor de 10 kg y 2.5 mg en niños con peso mayor a 10 kg. Se les realizó determinación de potasio sérica y gasometría al ingreso y 60 minutos después de la administración del salbutamol. Los niveles séricos de potasio al ingreso fueron entre 3.7 y 5.7 mmol/L (promedio 4.46); 60 minutos después fueron entre 3.3 y 4.7 mmol/L (promedio 4.1), con una disminución significativa de 0.36 mmol/L (p=0.01). no se encontraron diferencias significativas en las determinaciones de pH. Se concluye que el salbutamol nebulizado disminuye los niveles séricos de potasio significativamente 60 minutos después de su administración en niños con crisis asmática


Sujets)
Humains , Mâle , Femelle , Enfant d'âge préscolaire , Adolescent , Administration par inhalation , Salbutamol , Salbutamol/pharmacocinétique , État de mal asthmatique/traitement médicamenteux , Hypokaliémie/induit chimiquement , Potassium/sang
13.
Article Dans Anglais | IMSEAR | ID: sea-45830

Résumé

A Thai female patient developed muscular weakness, hypouricemia, hypokalemia and hyperchloremic metabolic acidosis after taking outdated tetracycline. A pathophysiologic study shows a proximal tubular defect for reabsorption of urate and bicarbonate and a distal tubular acidification defect, probably caused by outdated tetracycline.


Sujets)
Acidose tubulaire rénale/induit chimiquement , Adulte , Femelle , Humains , Hypokaliémie/induit chimiquement , Tétracycline/effets indésirables , Acide urique/sang
14.
Article Dans Anglais | IMSEAR | ID: sea-89449

Résumé

Diuretics are an important cause of symptomatic hyponatraemia in the elderly. The hyponatraemia is often associated with hypokalaemia which may play a role in the aetiology. Diuretic induced hyponatraemia must be considered in the differential diagnosis of elderly patients presenting with altered sensorium or seizures. This is especially important in those known to be hypertensives since diuretics are frequently used to treat hypertension in the elderly.


Sujets)
Sujet âgé , Diagnostic différentiel , Furosémide/usage thérapeutique , Humains , Hydrochlorothiazide/effets indésirables , Hypertension artérielle/traitement médicamenteux , Hypokaliémie/induit chimiquement , Hyponatrémie/induit chimiquement , Mâle , Chlorure de potassium/usage thérapeutique
17.
Article Dans Anglais | IMSEAR | ID: sea-94884

Résumé

Poisoning due to barium carbonate (rat poison) resulting in areflexic quadriplegia and respiratory muscle paresis in a young patient is described. The various effects of barium salts on the human body and their treatment are highlighted.


Sujets)
Adulte , Baryum/intoxication , Carbonates , Humains , Hypokaliémie/induit chimiquement , Mâle , Paralysie/induit chimiquement , Tétraplégie/induit chimiquement , Tentative de suicide/psychologie
18.
West Indian med. j ; 38(3): 183-6, Sept. 1989. ilus, tab
Article Dans Anglais | LILACS | ID: lil-81200

Résumé

A 65-year-old man with hypertension and glaucoma developed diuretic-induced hypokalaemia complicated by torsade de pointes ventricular tachycardia. This arrhythimia requires accurate recognition so that appropriate therapy may be administered. When torsade de pointes is diagnosed, a careful search for underlying causes should be conducted as revesal of these may prove curative, as in this case


Sujets)
Sujet âgé , Humains , Mâle , Tachycardie/étiologie , Hypokaliémie/complications , Antihypertenseurs/effets indésirables , Hypertension artérielle/traitement médicamenteux , Tachycardie/diagnostic , Hypokaliémie/induit chimiquement , Antihypertenseurs/usage thérapeutique
19.
West Indian med. j ; 37(2): 92-6, June 1988. tab
Article Dans Anglais | LILACS | ID: lil-77948

Résumé

Red cell sodium and potassium content were measured in 24 hypertensive patients while they were hypokalaemic on thiazide diuretic therapy and agin after potassium supplements (48 meq elemental K+/day). Mean and diastolic blood levels fell by 4.1-4.4 and 44.5-5.2 mmHg respectively with potassium supplementation, while both urinary excretion of potassium and serum potassium rose. Urinary sodium excretion was unchanged. Red cell potassium remained within the normal range but red cell sodium, initially high, fell with potassium therapy. This study confirms the importance of potassium supplementation where hypokalaemia results from diuretic therapy


Sujets)
Humains , Mâle , Femelle , Potassium/usage thérapeutique , Sodium/sang , Pression sanguine/effets des médicaments et des substances chimiques , Érythrocytes/analyse , Hypertension artérielle , Potassium/sang , Bendrofluméthiazide/effets indésirables , , Association de médicaments , Hypokaliémie/induit chimiquement , Jamaïque
20.
Med. crít. venez ; 1(3): 63-6, jul.-sept. 1986. ilus
Article Dans Espagnol | LILACS | ID: lil-41061

Résumé

Los diuréticos producen hipokalemia desde la primera semana de tratamiento fundamentalmente por aumento de oferta de fluido del mecanismo de contrasporte Na-K2Cl. La hipokalemia debe ser corregida con sales como cloruro de potasio. La incidencia de arritmias ventriculares serias (taquicardia y fibrilación) se incrementan significativamente con valores de potasio sérico menores de 3.6 ó 3.5 mEq/lit


Sujets)
Humains , Diurétiques/effets indésirables , Hypokaliémie/induit chimiquement , Troubles du rythme cardiaque/induit chimiquement , Diurétiques/pharmacologie , Potassium/métabolisme
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