Heparin-Induced Hyperkalemia Assessment Utilizing the Naranjo Adverse Drug Reaction Probability Scale: A 40-Year...

Area of Science:

• Pharmacovigilance
• Clinical Pharmacology
• Drug Safety

Background:

• Adverse drug reactions (ADRs) are significant causes of patient morbidity and mortality.
• Hyperkalemia is a known side effect of unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH), affecting 7-8% of patients.
• Standardized tools are needed to determine causality for heparin-induced hyperkalemia.

Purpose of the Study:

• To quantify case reports of hyperkalemia linked to UFH or LMWH.
• To assess the application of the Naranjo Adverse Drug Reaction Probability Scale in these cases.

Main Methods:

• Systematic literature search of PubMed, International Pharmaceutical Abstracts, and Cochrane Library.
• Searched for case reports using terms like 'hyperkalemia AND heparin' and 'hyperkalemia AND low molecular weight heparin'.
• Included studies on human specimens and limited to case report formats.

Main Results:

• Identified 29 case reports involving 38 patients.
• The Naranjo Scale was used in 5 cases (13.2%) to assess causality as probable for UFH or LMWH-induced hyperkalemia.
• Four cases involved UFH, and one involved LMWH.

Conclusions:

• Clinician utilization of the Naranjo Scale for assessing heparin-induced hyperkalemia is infrequent.
• There is a need to encourage the use of objective monitoring tools for ADR causality assessment.
• Standardized assessment is crucial for managing heparin-related adverse drug reactions.