PURPOSE: Detection and reporting of drug-induced life-threatening potassium disturbances and the study of associated factors under a Pharmacovigilance Program using Laboratory Signals at a Hospital (PPLSH) during a 2-year period. METHODS: All serum potassium levels <2 mmol/l or >7 mmol/l detected at admission to the hospital, including those of patients who died in the emergency ward or during hospitalization, were monitored prospectively from January 2009 through to December 2010. The incidence rate of each etiology of potassium disturbances was calculated. Factors associated with drug-induced potassium disturbances were detected using a multiple logistic regression model. RESULTS: The incidence of true life-threatening drug-induced hyper- and hypokalemia events was 3 and 4.32 (Poisson 95 % confidence interval 1.62-10.24), respectively, per 10,000 admissions. Of the severe potassium disturbances, 32.3 % were drug-induced, and 23 % were lethal. We identified previously undescribed pharmacological causes of hyperkalemia (risedronate, doxazosin) and hypokalemia (acyclovir, teicoplanin, cefepime, meropenem, dexketoprofen colistimethate). Significant predictor factors associated with drug-induced hyperkalemia were the use of polypharmacy (>5 drugs), age (>74 years), sex (female) and kidney disease (glomerular filtration rate <60 ml/min) with the presence of ≥4 comorbid conditions. The only predictor of drug-induced hypokalemia was the use of >5 drugs. The triggering factor associated with drug-induced hyperkalemia and hypokalemia was azotemia and hypoalbuminemia, respectively. CONCLUSIONS: Drug-induced life-threatening potassium disturbances remain a relevant problem. Potential strategies for prevention are to avoid polypharmacy, early discontinuation of treatment of drugs causing hyperkalemia or nephrotoxicity in cases of various clinical situations (cardiac descompensation, infection, hypovolemia) or obstructive causes, and insistence on albumin control during hospitalization.
PURPOSE: Detection and reporting of drug-induced life-threatening potassium disturbances and the study of associated factors under a Pharmacovigilance Program using Laboratory Signals at a Hospital (PPLSH) during a 2-year period. METHODS: All serum potassium levels <2 mmol/l or >7 mmol/l detected at admission to the hospital, including those of patients who died in the emergency ward or during hospitalization, were monitored prospectively from January 2009 through to December 2010. The incidence rate of each etiology of potassium disturbances was calculated. Factors associated with drug-induced potassium disturbances were detected using a multiple logistic regression model. RESULTS: The incidence of true life-threatening drug-induced hyper- and hypokalemia events was 3 and 4.32 (Poisson 95 % confidence interval 1.62-10.24), respectively, per 10,000 admissions. Of the severe potassium disturbances, 32.3 % were drug-induced, and 23 % were lethal. We identified previously undescribed pharmacological causes of hyperkalemia (risedronate, doxazosin) and hypokalemia (acyclovir, teicoplanin, cefepime, meropenem, dexketoprofen colistimethate). Significant predictor factors associated with drug-induced hyperkalemia were the use of polypharmacy (>5 drugs), age (>74 years), sex (female) and kidney disease (glomerular filtration rate <60 ml/min) with the presence of ≥4 comorbid conditions. The only predictor of drug-induced hypokalemia was the use of >5 drugs. The triggering factor associated with drug-induced hyperkalemia and hypokalemia was azotemia and hypoalbuminemia, respectively. CONCLUSIONS: Drug-induced life-threatening potassium disturbances remain a relevant problem. Potential strategies for prevention are to avoid polypharmacy, early discontinuation of treatment of drugs causing hyperkalemia or nephrotoxicity in cases of various clinical situations (cardiac descompensation, infection, hypovolemia) or obstructive causes, and insistence on albumin control during hospitalization.
Authors: Pernelle Noize; Haleh Bagheri; Geneviève Durrieu; Françoise Haramburu; Nicholas Moore; Patrick Giraud; Michel Galinier; Jacques Pourrat; Jean-Louis Montastruc Journal: Pharmacoepidemiol Drug Saf Date: 2011-03-16 Impact factor: 2.890
Authors: André Gustavo P Sousa; João Victor de Sousa Cabral; William Batah El-Feghaly; Luísa Silva de Sousa; Adriana Bezerra Nunes Journal: World J Diabetes Date: 2016-03-10
Authors: Emmanuel Eschmann; Patrick E Beeler; Vladimir Kaplan; Markus Schneemann; Gregor Zünd; Jürg Blaser Journal: Eur J Clin Pharmacol Date: 2013-10-23 Impact factor: 2.953
Authors: Masatoshi Minamisawa; Brian Claggett; Kota Suzuki; Sheila M Hegde; Amil M Shah; Akshay S Desai; Eldrin F Lewis; Sanjiv J Shah; Nancy K Sweitzer; James C Fang; Inder S Anand; Eileen O'Meara; Jean-Lucien Rouleau; Bertram Pitt; Marc A Pfeffer; Scott D Solomon; Orly Vardeny Journal: Circ Heart Fail Date: 2021-10-22 Impact factor: 8.790
Authors: Lamyaa M Kassem; Bushra Alhabib; Khaledah Alzunaydi; Maryam Farooqui Journal: Int J Environ Res Public Health Date: 2021-04-07 Impact factor: 3.390