Drug-induced hyperkalemia: Old culprits and new offenders

Prescribed medications, over-the-counter drugs, and nutritional supplements are used by many patients. Although most of these products are well tolera ted, drug-induced hyperkalemia may develop in patients with underlying rena l impairment or other abnormalities in potassium handling. Drug-induced hyp erkalemia most often occurs from impaired renal potassium excretion. Howeve r, disturbed cellular uptake of a potassium load as well as excessive inges tion or infusion of potassium-containing substances may also occur. Physici ans must be aware of medications that can precipitate hyperkalemia, how the se drugs induce alterations in potassium homeostasis, and the patient chara cteristics that increase the risk of hyperkalemia. Am J Med. 2000;109:307-3 14. (C) 2000 by Excerpta Medica, Inc.