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吲达帕胺起始治疗10天内出现严重电解质紊乱并伴有癫痫发作和急性肾损伤

Severe Electrolyte Disturbances Complicated by Seizures and Acute Kidney Injury Within 10 Days of Starting Indapamide.

作者信息

Alamin Mohammed A, Ahmed Ashraf, Suliman Aasir M

机构信息

Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, QAT.

出版信息

Cureus. 2020 Nov 2;12(11):e11303. doi: 10.7759/cureus.11303.

Abstract

Indapamide is one of the most effective and well-known anti-hypertensive medications. Electrolyte disturbances have been classically recognized as a typical side effect profile of indapamide. The most common electrolyte imbalance described with indapamide was hypokalemia; however, hyponatremia is being increasingly reported. In this case, we report a unique form of severe electrolytes derangement (hyponatremia, hypokalemia, hypophosphatemia, and hypocalcemia), which was complicated by seizures, rhabdomyolysis, and acute kidney injury that occurred within only 10 days of indapamide initiation. The patient was admitted to the medical intensive care unit for prompt electrolyte replacement and close monitoring. With the discontinuation of indapamide and the prompt replacement of the deficient electrolytes, the patient's condition has improved dramatically, and he was discharged in a good state of health. Electrolyte disturbances are expected to be seen with indapamide usage, and it might be associated with severe consequences like arrhythmias and seizures. This case report would raise awareness and add to the importance of closely following patients after prescribing indapamide.

摘要

吲达帕胺是最有效且最知名的抗高血压药物之一。电解质紊乱一直被公认为是吲达帕胺的典型副作用。与吲达帕胺相关的最常见电解质失衡是低钾血症;然而,低钠血症的报告也越来越多。在本病例中,我们报告了一种独特的严重电解质紊乱形式(低钠血症、低钾血症、低磷血症和低钙血症),在开始使用吲达帕胺仅10天内就并发了癫痫发作、横纹肌溶解和急性肾损伤。患者被收入医疗重症监护病房以便迅速补充电解质并密切监测。随着吲达帕胺停用以及迅速补充缺乏的电解质,患者病情显著改善,出院时健康状况良好。使用吲达帕胺时预计会出现电解质紊乱,并且可能会导致心律失常和癫痫发作等严重后果。本病例报告将提高认识,并增加在开具吲达帕胺处方后密切随访患者的重要性。

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