Perazella M A
Section of Nephrology, Department of Medicine, Yale University School of Medicine, New Haven, CT 06520-8029, USA.
Am J Ther. 1997 Sep-Oct;4(9-10):343-8. doi: 10.1097/00045391-199709000-00010.
Trimethoprim-sulfamethoxazole is a commonly prescribed antimicrobial agent. Twenty-five years after its introduction into clinical practice, an unrecognized and potentially lethal adverse reaction associated with trimethoprim-sulfamethoxazole therapy, hyperkalemia, was described. Both "high-dose" and "standard-dose" trimethoprim-sulfamethoxazole have been associated with this electrolyte disorder. Recognition of this potassium disturbance led to the subsequent description of the mechanism by which trimethoprim-sulfamethoxazole induced hyperkalemia. Trimethoprim was found to act like the potassium-sparing diuretic amiloride and reduce renal potassium excretion. Hence, trimethoprim is in fact a potassium-sparing diuretic like amiloride and causes hyperkalemia in high-risk patients.
甲氧苄啶-磺胺甲恶唑是一种常用的抗菌药物。在其引入临床实践25年后，一种与甲氧苄啶-磺胺甲恶唑治疗相关的未被认识到的潜在致命不良反应——高钾血症被描述出来。“高剂量”和“标准剂量”的甲氧苄啶-磺胺甲恶唑都与这种电解质紊乱有关。对这种钾紊乱的认识导致了随后对甲氧苄啶-磺胺甲恶唑诱发高钾血症机制的描述。发现甲氧苄啶的作用类似于保钾利尿剂阿米洛利，并减少肾脏钾排泄。因此，甲氧苄啶实际上是一种像阿米洛利一样的保钾利尿剂，会在高危患者中引起高钾血症。
