Fatal hyperkalemia related to combined therapy with a COX-2 inhibitor, ACE inhibitor and potassium rich diet
Fatal hyperkalemia related to combined therapy with a COX-2 inhibitor, ACE inhibitor and potassium rich diet
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DOI：
10.1016/s0736-4679(02)00434-1
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发表时间：
2002-05-01
影响因子：
1.5
通讯作者：
Armoni, M
中科院分区：
文献类型：
--
作者：
Hay, E;Derazon, H;Armoni, M
我们描述了一名 77 岁轻度高血压女性的病例，她没有潜在的肾脏疾病，她因发烧昏迷而被送往急诊科 (ED)。该患者一直服用低剂量依那普利和富含钾的饮食。入院前五天，加用罗非昔布（一种新型选择性 COX-2 抑制剂非甾体抗炎药 (NSAID)）治疗腿部疼痛。她被发现患有严重高钾血症，并在抵达后90分钟死亡。我们不能绝对确定 COX-2 抑制剂是否是高钾血症发生的主要因素，或者是联合用药本身，并伴有并发感染和一定程度的脱水。医生应该意识到这种可能的并发症，并且只在密切监测肾功能和电解质测试的情况下给老年人开非甾体抗炎药（包括新型 COX-2 药物）。 (C) 2002 爱思唯尔科学公司。
We describe the case of a 77-year old mildly hypertensive woman with no underlying renal disease who was admitted to the Emergency Department (ED) in a comatose state with fever. The patient had been on low dose enalapril and a potassium rich diet. Five days before admission, rofecoxib, a new selective COX-2 inhibitor nonsteroidal anti-inflammatory drug (NSAID), was added for leg pain. She was found to have severe hyperkalemia and died 90 min after her arrival. We cannot absolutely determine whether the COX-2 inhibitor was the dominant contributor to the development of hyperkalemia or the combination itself, with an intercurrent infection and some degree of dehydration. Physicians should be aware of this possible complication and only prescribe NSAIDs, including the new COX-2 drugs, to the elderly under close monitoring of kidney function and electrolyte tests. (C) 2002 Elsevier Science Inc.