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Related Concept Videos

Antihypertensive Drugs: Potassium-Sparing Diuretics01:28

Antihypertensive Drugs: Potassium-Sparing Diuretics

Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of the heart's...
Antiepileptic Drugs: Potassium Channel Activators01:20

Antiepileptic Drugs: Potassium Channel Activators

Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...

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Related Experiment Video

Updated: Jul 23, 2026

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
08:56

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Published on: September 24, 2021

Severe hyperkalemia during piroxicam therapy.

K P Miller, E J Lazar, S Fotino

    Archives of Internal Medicine
    |December 1, 1984
    PubMed
    Summary

    Piroxicam, a nonsteroidal anti-inflammatory drug, can cause severe hyperkalemia (high potassium) and non-anion gap acidosis. These conditions resolved after discontinuing piroxicam and initiating treatment.

    Area of Science:

    • Nephrology
    • Pharmacology
    • Internal Medicine

    Background:

    • Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for pain and inflammation.
    • Potential adverse effects of NSAIDs include renal complications.
    • Hyperkalemia is a serious electrolyte imbalance that can lead to cardiac arrhythmias.

    Observation:

    • An 85-year-old male developed severe hyperkalemia (serum potassium 9.3 mEq/L) and non-anion gap metabolic acidosis during several months of piroxicam treatment.
    • Laboratory findings at admission included low total CO2 (11 mmole/L), elevated serum urea nitrogen (54 mg/dL), and creatinine (2.5 mg/dL).
    • Plasma renin activity was abnormally low and aldosterone concentration was low.

    Findings:

    • Discontinuation of piroxicam and treatment with polystyrene sodium sulfonate led to the resolution of hyperkalemia and acidosis.

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  • Renal function (serum urea nitrogen and creatinine) remained unchanged.
  • Plasma renin activity normalized over time, while aldosterone levels remained low.

    • Implications:

    • Piroxicam may impair renin secretion, adrenal responsiveness to angiotensin, or aldosterone action on the renal tubules, leading to hyperkalemia and acidosis.
    • This case highlights the importance of monitoring electrolytes in patients receiving long-term NSAID therapy.
    • Physicians should consider NSAID-induced hyperkalemia in patients presenting with elevated potassium levels, particularly those with risk factors.