Background and Importance Hyperkalaemia is a frequent electrolyte alteration (EA) in hospital patients (HP). Thus, close monitoring of plasma potassium levels (PKL) and appropriately management is necessary. High levels of potassium may lead to heart and muscle disorders.
Aim and Objectives Main objectives are to evaluate and monitor hyperkalaemia in HP, to study risk factors and potentially implicated drugs (PIDs) and to analyse the degree of acceptance (DA) of the pharmaceutical interventions on PKL normalisation.
Material and Methods Observational, descriptive and prospective study from October 2021 to January 2022.
Patients with hyperkalaemia (K+> 5.3mEq/L) in the first 24 hours were evaluated with the assistance of an EA locator included in the health record system.
PKL were classified as minor (5.3-5.9 mEq/L), moderate (6-6.5mEq/L) or severe (>6.5mEq/L).
Age, sex, basal PKL and measured PKL four days after, prescribed PIDs, comorbidities such as kidney impairment (KI), previous therapeutic approach or dietary potassium restrictions (DKR) were collected.
Depending on the PKL and the patient characteristics, different recommendations were made: discontinuation of potassium-containing serums; PKL monitoring and DKR consideration in minor hyperkalaemia cases; ion-exchange resin (IER) evaluation when patients with moderate-severe hyperkalaemia tolerated oral intake. If there were any prescribed PIDs, pharmacists recommended an alternative.
PKL were evaluated after interventions and DA was determined.
Results We analysed 87 patients. 64,4% were men and the average age was 77. The most accepted recommendations were: discontinuation of potassium-containing serums (DA 100%), PKL monitoring and DKR (DA 64.2%) and IER prescription (DA 46.15%). The proposed alternatives to PIDs had not a high DA. The PIDs prescribed were heparin 58.6%, renin-angiotensin system inhibitors 39%, anti-inflammatory drugs 27.9% and K-sparing diuretics 3.4%. 66.7% of the patients were treated with more than one PID, 41% of them had KI.
We made an intervention in 40,2% of the cases. The DA was 65,7% with a 60.8% of PKL normalisation versus a 25% of recovery in those patients with non-accepted intervention.
Conclusion and Relevance Hyperkalaemia is more frequent in men and patients with KI. There is an association between PID co-prescription and hyperkalaemia episodes.
The development of pharmaceutical validation support tools such as EA locators provides the screening and monitoring of disorders that might trigger health consequences.
Conflict of Interest No conflict of interest
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