Weiss M, Hess T
Medizinische Abteilung, Anna-Seiler-Haus, Inselspital, Bern.
Schweiz Rundsch Med Prax. 1991 Jan 15;80(3):41-5.
In two cases with drug-related hyperkalemia, potassium homeostasis, causes, symptoms and therapy are discussed. Iatrogenic and therefore avoidable hyperkalemia occurs most often when potassium, ACE-inhibitors, nonsteroidal antiinflammatory drugs or potassium-sparing diuretics are administered in patients with impaired renal function or diabetes mellitus. The emergency treatment in patients with severe hyperkalemia consists of intravenous calcium injections, infusion of glucose with insulin and, more recently, salbutamol. With acidotic patients administration of sodium-bicarbonate can be tried. Ion-exchange drugs and furosemide have a more delayed effect. With oliguria and anuria hemodialysis is often necessary.
在两例药物相关性高钾血症病例中,讨论了钾稳态、病因、症状及治疗方法。医源性且因此可避免的高钾血症最常发生于肾功能受损或患有糖尿病的患者使用钾、血管紧张素转换酶抑制剂、非甾体抗炎药或保钾利尿剂时。重度高钾血症患者的紧急治疗包括静脉注射钙剂、输注葡萄糖加胰岛素,以及最近使用的沙丁胺醇。对于酸中毒患者,可尝试给予碳酸氢钠。离子交换药物和呋塞米的作用起效较迟。对于少尿和无尿患者,往往需要进行血液透析。