Department of Pharmacy (MSB), Banner Good Samaritan Medical Center, Phoenix, AZ, USA.
Crit Care Med. 2010 Jun;38(6 Suppl):S253-64. doi: 10.1097/CCM.0b013e3181dda0be.
Electrolyte imbalances are common in critically ill patients. Although multiple disease states typically encountered in the intensive care unit may be responsible for the development of electrolyte disorders, medications may contribute to these disturbances as well. Medications can interfere with the absorption of electrolytes, alter hormonal responses affecting homeostasis, as well as directly impact organ function responsible for maintaining electrolyte balance. The focus on this review is to identify commonly prescribed medications in the intensive care unit and potential electrolyte disturbances that may occur as a result of their use. This review will also discuss the postulated mechanisms associated with these drug-induced disorders. The specific drug-induced electrolyte disorders discussed in this review involve abnormalities in sodium, potassium, calcium, phosphate, and magnesium. Clinicians encountering electrolyte disturbances should be vigilant in monitoring the patient's medications as a potential etiology. Insight into these drug-induced disorders should allow the clinician to provide optimal medical management for the critically ill patient, thus improving overall healthcare outcomes.
电解质失衡在危重症患者中很常见。尽管重症监护病房中常见的多种疾病状态可能导致电解质紊乱,但药物也可能导致这些紊乱。药物会干扰电解质的吸收,改变影响体内平衡的激素反应,以及直接影响负责维持电解质平衡的器官功能。本综述的重点是确定重症监护病房中常用的药物以及由于这些药物的使用可能发生的潜在电解质紊乱。本综述还将讨论与这些药物引起的疾病相关的假设机制。本综述中讨论的特定药物引起的电解质紊乱涉及钠、钾、钙、磷和镁的异常。遇到电解质紊乱的临床医生应警惕监测患者的药物,因为这可能是潜在的病因。深入了解这些药物引起的疾病应使临床医生能够为危重症患者提供最佳的医疗管理,从而改善整体医疗保健结果。