PT  - JOURNAL ARTICLE
AU  - C Dávila Fajardo
AU  - D Blanquez Martinez
AU  - A Caballero Romero
AU  - C Gonzalez Medina
AU  - R Moron Romero
TI  - CP-047 How to respond to high levels of serum potassium
AID  - 10.1136/ejhpharm-2013-000436.46
DP  - 2014 Mar 01
TA  - European Journal of Hospital Pharmacy: Science and Practice
PG  - A19--A19
VI  - 21
IP  - Suppl 1
4099  - http://ejhp.bmj.com/content/21/Suppl_1/A19.1.short
4100  - http://ejhp.bmj.com/content/21/Suppl_1/A19.1.full
SO  - Eur J Hosp Pharm2014 Mar 01; 21
AB  - Background Hyperkalaemia is an elevated serum potassium level above 5.5 mmol/L. It can be due to an increased intake, redistribution or decreased renal excretion of potassium. Very high levels of potassium are a medical emergency because of the risk of cardiac arrhythmias. Purpose To analyse treatment that may cause hyperkalaemia in in-patients. To evaluate the percentage acceptance of hyperkalaemia recommendations made by the clinical pharmacist. Materials and methods A descriptive, retrospective study of 6 months in which we reviewed the prescriptions of patients with potassium serum levels ≥5.5 mmol/L using the electronic medical record (Archinet). Variables collected: age, sex, weight, serum creatinine and drugs. Results 1,500 determinations of potassium serum were read. 4.6% (70/1500) had a value ≥5.5 mmol/L. These 70 measurements belonged to 50 different patients (35 women and 25 men). The average age was 85 years (58–102). The creatinine clearance was ≥60 mL/min for 5/88 determinations, 30–59 mL/min for 25/88 determinations and ≤23 mL/min for 40/88. All the patients were being treated with drugs associated with hyperkalaemia, except one patient. 140 suspected drugs were identified that might have caused the problem: LMWH 46.4%, 14.6% ACE inhibitors, digoxin 10.6%, 7.3% potassium-sparing diuretics, 5.3% parenteral potassium, 4.1% other drugs. 28 recommendations were made to optimise the treatment but only in 14 cases was the suggestion accepted. The proposals included recommendations for reducing a dose, discontinuing drugs known to cause hyperkalaemia, and proposals for monitoring drugs suspected of causing hyperkalaemia. Conclusions Many commonly-used drugs can cause hyperkalaemia. Renal function is impaired in the majority of patients with drug-induced hyperkalaemia. The pharmacy department shall systematically review the potassium serum levels in in-patients and make recommendations. In our study, the degree of acceptance of the recommendations was moderate. No conflict of interest.