Rahman A R, McDevitt D G, Struthers A D, Lipworth B J
Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee, Scotland.
Chest. 1992 Jul;102(1):91-5. doi: 10.1378/chest.102.1.91.
To investigate whether enalapril (E) 10 mg and spironolactone (S) 100 mg attenuate the hypokalemic effect of inhaled terbutaline (T).
Randomized single-blind crossover. Subjects received the following treatment combinations: (a) placebo (P), (b) T alone, (c) T + E, or (d) T + S.
University Department of Clinical Pharmacology.
Twenty healthy volunteers (ten male, ten female) of mean age 22.8 +/- 3.1 years.
Serum potassium, magnesium, ECG changes (R-R interval, T wave, and QTc interval) for 4 h after terbutaline inhalation.
Baseline serum potassium levels were higher following prior treatment with E and S; P, 3.78 mmol/L (3.67 to 3.88); T + E, 3.93 mmol-1 (3.82 to 4.03); and T + S, 4.03 mmol/L (3.93 to 4.14) (p less than 0.05). Mean potassium concentrations over 4 h were also higher following prior treatment with E and S; T, 3.58 mmol/L (3.54 to 3.63); T + E, 3.68 mmol/L (3.64 to 3.72) (p less than 0.05); and T + S, 3.73 mmol/L (3.68 to 3.78) (p less than 0.01).
Enalapril and spironolactone protect against the fall in serum potassium over 4 h by elevating baseline potassium concentration. These potassium-sparing drugs, however, should not be used to prevent the hypokalemic and electrocardiographic sequelae of inhaled beta 2-agonists.
研究依那普利（E）10毫克和螺内酯（S）100毫克是否能减轻吸入特布他林（T）引起的低钾血症效应。
随机单盲交叉试验。受试者接受以下治疗组合：（a）安慰剂（P），（b）单独使用T，（c）T + E，或（d）T + S。
大学临床药理系。
20名健康志愿者（10名男性，10名女性），平均年龄22.8±3.1岁。
吸入特布他林后4小时的血清钾、镁水平及心电图变化（R-R间期、T波和QTc间期）。
先前使用E和S治疗后，基线血清钾水平较高；P组为3.78毫摩尔/升（3.67至3.88）；T + E组为3.93毫摩尔/升（3.82至4.03）；T + S组为4.03毫摩尔/升（3.93至4.14）（p<0.05）。先前使用E和S治疗后，4小时内的平均钾浓度也较高；T组为3.58毫摩尔/升（3.54至3.63）；T + E组为3.68毫摩尔/升（3.64至3.72）（p<0.05）；T + S组为3.73毫摩尔/升（3.68至3.78）（p<0.01）。
依那普利和螺内酯通过提高基线钾浓度来防止血清钾在4小时内下降。然而，这些保钾药物不应被用于预防吸入β2激动剂引起的低钾血症和心电图后遗症。
