Marinella M A
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109, USA.
Am J Med Sci. 1995 Sep;310(3):115-7. doi: 10.1097/00000441-199531030-00006.
Trimethoprim-sulfamethoxazole (TMP-SMX) is a fixed-dose antimicrobial agent used in a variety of infections. Adverse reactions are more common in patients with AIDS, but occasionally occur in immunocompetent patients. Renal toxicity is usually a hypersensitivity reaction to the sulfa component, and manifests as interstitial nephritis or sulfa crystallization in the renal tubules. Reversible hyperkalemia is a rarely reported side effect of TMP-SMX therapy attributed to TMP inhibition of potassium secretion in the distal renal tubule in a manner similar to the potassium sparing diuretic, amiloride. In this article, the author reports a case of hyperkalemia associated with TMP-SMK occurring in an elderly man with no other risk factors for hyperkalemia, which resolved upon discontinuation of the drug.
复方新诺明（TMP-SMX）是一种用于多种感染的固定剂量抗菌药物。不良反应在艾滋病患者中更为常见，但偶尔也会发生在免疫功能正常的患者身上。肾毒性通常是对磺胺成分的过敏反应，表现为间质性肾炎或肾小管磺胺结晶。可逆性高钾血症是复方新诺明治疗罕见的副作用，其原因是甲氧苄啶抑制远端肾小管钾分泌，方式类似于保钾利尿剂阿米洛利。在本文中，作者报告了一例在无其他高钾血症危险因素的老年男性中发生的与复方新诺明相关的高钾血症病例，停药后高钾血症得以缓解。
