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Old 05-12-2012
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Drug NSAIDs and hyperkalemia

How does use of nsaids cause hyperkalemia?
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Old 05-12-2012
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Decreased prostaglandin production leads to decreased afferent arteriolar flow, suppressing renin and aldosterone secretion.
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Old 05-19-2012
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Originally Posted by svmle View Post
How does use of nsaids cause hyperkalemia?

NSAIDs lower renal renin secretion, which is normally mediated in part by locally produced prostaglandins and they impair angiotensin II-induced aldosterone release..... The fall in aldosterone secretion will reduce urinary potassium excretion, which will tend to raise the plasma potassium concentration........!!!
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Old 05-19-2012
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Drugs Associated with Hyperkalemia

There are a variety of drugs which can result in hyperkalemia, via a variety of mechanisms. Here are a list of some of the common offenders, categorized loosely based on mechanism, though admittedly there is some overlap between categories:

1. Drugs which cause translocation of K from the intracellular to the extracellular fluid: these include succinylcholine, isoflurane, minoxidil, and beta-blockers.

2. Potassium-Sparing Diuretics: drugs such as spironolactone (mineralocorticoid receptor antagonists) and amiloridine/triamterene (blockers of the ENaC) are common causers of hyperkalemia.

3. Inhibitors of renin-angiotensin-aldosterone axis: ACE-inhibitors, angiotensin receptor blockers.

4. Hyperosmolarity: hyperosmolarity induces water efflux out of cells, and by solvent drag increases intravascular potassium concentrations. Drugs such as mannitol can therefore cause translocational hyperkalemia.

5. NSAIDs: NSAIDs can lower renin secretion, which is normally mediated in part by locally-produced prostaglandins.

6. Bactrim: the hyperkalemia induced by Bactrim is via an ENaC inhibitory effect exerted by the trimethoprim moiety. Pentamidine induced hyperkalemia via a similar mechanism.

7. calcineurin inhibitors (e.g., cyclosporine, tacrolimus): it is postulated that these medications inhibit renal tubular responsiveness to aldosterone.

8. heparin & ketoconazole: these drugs may be associated by hyperkalemia by inhibiting aldosterone synthesis.

9. digitalis: digitalis inhibits the Na-K ATPase (which pumps 3 Na out of the cell and 2 K in); as such, it can result in hyperkalemia and a variety of cardiac arrhythmias.
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