Howes L G
Department of Clinical Pharmacology, St George Hospital, Kogarah, NSW, Australia.
Drug Saf. 1995 Apr;12(4):240-4. doi: 10.2165/00002018-199512040-00003.
A number of drugs can affect potassium levels by a variety of different mechanisms. Diuretics remain the most important cause of drug-induced alterations. ACE inhibitors may produce hyperkalaemia, particularly in patients with autonomic neuropathy, adrenal insufficiency, renal impairment and when used in combination with nonsteroidal anti-inflammatory drugs (NSAIDs). Cathartic and/or diuretic abuse should be suspected when hypokalaemia occurs in young patients suspected of having an eating disorder. NSAIDs may occasionally produce hyperkalaemia, particularly in patients with renal impairment or when used with ACE inhibitors. Sympathomimetics and theophylline derivatives may lower serum potassium levels, but this is usually only of clinical significance when overdosage occurs.
许多药物可通过多种不同机制影响钾水平。利尿剂仍然是药物引起的钾水平改变的最重要原因。血管紧张素转换酶（ACE）抑制剂可能会导致高钾血症，尤其是在患有自主神经病变、肾上腺功能不全、肾功能损害的患者中，以及与非甾体抗炎药（NSAIDs）联合使用时。当怀疑患有饮食失调的年轻患者出现低钾血症时，应怀疑有泻药和/或利尿剂滥用的情况。NSAIDs偶尔可能会导致高钾血症，尤其是在肾功能损害患者中或与ACE抑制剂合用时。拟交感神经药和茶碱衍生物可能会降低血清钾水平，但这通常仅在过量用药时具有临床意义。
