HYPOKALEMIA RELATED TO ACUTE CHLOROQUINE INGESTION

Large doses of chloroquine can cause poisoning. Our aim was to determi ne the possible relation between the plasma potassium concentration on admission with the severity of acute chloroquine poisoning and to ass ess the mechanism of chloroquine-induced hypokalaemia. We conducted a retrospective study of 191 consecutive cases. The main data included t he occurrence of vomiting before admission, plasma, and urinary potass ium concentration at admission, whole blood chloroquine concentration on admission, haemodynamic parameters and EGG, administration of catec holamines and outcome. Mean blood chloroquine level was 20.1 mu mol/L (SD 14.3) (therapeutic level less than or equal to 6 mu mol/L). Mean p lasma potassium concentration was 3.0 mmol/L (0.8) and was lower in th e subjects who died than in those who survived (p=0.0003). Plasma pota ssium varied directly with the systolic blood pressure and inversely w ith the QRS and QT. Plasma potassium varied inversely with the blood c hloroquine (p=0.0001; tau=-0.42). Acute chloroquine intoxication is re sponsible for a hypokalaemia which correlates with the gravity of the intoxication and may be due to a transport-dependent mechanism. Plasma potassium concentrations should be carefully observed, particularly a mong patients who also receive catecholamine infusions. We should keep in mind, however, that overzealous repletion invokes the risk of subs equent hyperkalaemia and thus should be avoided.