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Severe hypokalaemia from kaolin and morphine abuse
Postgraduate Medical Journal
|July 1, 1987
Summary
Excessive use of kaolin and morphine mixture caused severe hypokalemia (low potassium) in a patient with muscle weakness. Potassium replacement fully restored muscle strength, highlighting the dangers of this medication combination.
Area of Science:
- Internal Medicine
- Clinical Pharmacology
- Toxicology
Background:
- Kaolin and morphine mixture is commonly used for gastrointestinal complaints.
- Patients may misuse medications, leading to adverse effects.
- Muscle weakness can be a symptom of electrolyte imbalances.
Observation:
- A 34-year-old man with pre-existing muscle weakness presented with increasing weakness.
- He was found to have profound hypokalemia (low potassium levels).
- The patient reported daily consumption of up to 1400 ml of kaolin and morphine mixture.
Findings:
- The patient's hypokalemia was attributed to the liquorice extract and sodium bicarbonate components in the kaolin and morphine mixture.
- Following significant potassium replacement therapy, the patient's muscle power completely recovered.
Implications:
- This case highlights the potential for medication misuse to cause severe electrolyte disturbances.
- Healthcare providers should inquire about the quantity of over-the-counter medications used by patients.
- Awareness of the ingredients in commonly used remedies is crucial for preventing adverse drug events.