OCTREOTIDE-INDUCED HYPERKALEMIA

A 68-year-old woman was admitted with numerous injuries after being hi t by an automobile. On day 16 of hospitalization octreotide was starte d for treatment of a pancreatic fistula, and within 2 days the patient 's serum potassium increased. By the third and fourth days of octreoti de therapy the level had increased to the point at which it required t reatment. The patient was asymptomatic, however, and had normal renal function. Octreotide was discontinued on the fifth day of the course, with a subsequent decrease in serum potassium. Two days later, one dos e of the drug.was given; serial serum potassium levels were measured b efore and after the dose, and increased after the rechallenge. Octreot ide was not administered for the remainder of the patient's hospitaliz ation, and hyperkalemia did not recur.