Hsu I, Wordell C J
Thomas Jefferson University Hospital, Philadelphia, PA 19103, USA.
Ann Pharmacother. 1995 Apr;29(4):427-9. doi: 10.1177/106002809502900415.
Evidence from the literature strongly supports that high doses of TMP, as used in the treatment of PCP in AIDS patients, have the propensity to cause hyperkalemia by inhibiting sodium channels in the distal nephron, thereby impairing potassium secretion. The mechanism of TMP-induced hyperkalemia is believed to be similar to that of triamterene and amiloride because of the structural similarity of these agents. It is also possible that declining renal function, which is a natural progression of HIV disease, may contribute to the hyperkalemia seen in this patient population. In addition, patients with AIDS also may exhibit a defect in adrenal function, potentiating the hyperkalemic effect of TMP therapy. Therefore, it is crucial for clinicians to monitor closely the serum potassium concentration in this patient population, especially during therapy with high doses of TMP.
文献证据有力地支持，用于治疗艾滋病患者肺孢子菌肺炎（PCP）的高剂量甲氧苄啶（TMP），有通过抑制远端肾单位的钠通道而导致高钾血症的倾向，从而损害钾分泌。由于这些药物的结构相似，TMP诱导高钾血症的机制被认为与氨苯蝶啶和阿米洛利相似。肾功能下降是HIV疾病的自然进展过程，这也可能导致该患者群体出现高钾血症。此外，艾滋病患者也可能表现出肾上腺功能缺陷，增强了TMP治疗的高钾血症效应。因此，对于临床医生来说，密切监测该患者群体的血清钾浓度至关重要，尤其是在使用高剂量TMP治疗期间。
