Condition (s) associated with hypokalemia except -
Type IV A is the only type characterized by a hyperkalemic, hyperchloremic acidosis. CAUSES OF HYPOKALEMIA Inadequate potassium intake Eating disorders : Anorexia, bulimia, starvation, pica, and alcoholism Dental problems: Impaired ability to chew or swallow Povey: Inadequate quantity or quality of food (eg, "tea-and-toast" diet of elderly individuals) Hospitalization: Potassium-poor TPN Increased potassium excretion Mineralocoicoid excess (endogenous or exogenous) Hyperreninism from renal aery stenosis Osmotic diuresis: Mannitol and hyperglycemia can cause osmotic diuresis Increased gastrointestinal losses Drugs Genetic disorders Endogenous sources of excess mineralocoicoid include the following: <a href=" syndrome</a> Primary hyperaldosteronism, most commonly from an adrenal adenoma or bilateral adrenal hyperplasia Secondary hyperaldosteronism from volume depletion, congestive hea failure, cirrhosis, or vomiting Tumor that is producing adrenocoicotropic hormone Genetic disorders Exogenous causes of mineralocoicoid excess include the following: Steroid therapy for immunosuppression Glycyrrhizic acid - Inhibits 11-beta hydroxysteroid dehydrogenase; contained in licorice and Chinese herbal preparations Renal tubular disorders - Type I and type II renal tubular acidosis Hypomagnesemia Drugs that can cause hypokalemia include the following: Diuretics (carbonic anhydrase inhibitors, loop diuretics, thiazide diuretics): Increased collecting duct permeability or increased gradient for potassium secretion can result in losses Methylxanthines (theophylline, aminophylline, caffeine) Verapamil (with overdose) Quetiapine (paicularly in overdose) Ampicillin, carbenicillin, high-dose penicillins Bicarbonate Antifungal agents (amphotericin B, azoles, echinocandins) Gentamicin Cisplatin Ephedrine (from Ephedra; banned in the United States, but available over the Internet) Beta-agonist intoxication Genetic disorders Congenital adrenal hyperplasia (11-beta hydroxylase or 17-alpha hydroxylase deficiency) Glucocoicoid-remediable hypeension Bater syndrome Gitelman syndrome Liddle syndrome Gullner syndrome Glucocoicoid receptor deficiency Hypokalemic period paralysis Thyrotoxic periodic paralysis (TTPP) Seizures, sensorineural deafness, ataxia, mental retardation, and electrolyte imbalance (SeSAME syndrome) A shift of potassium to the intracellular space may result from any of the following: Alkalosis (metabolic or respiratory) Insulin administration or glucose administration (the latter stimulates insulin release) Intensive beta-adrenergic stimulation Hypokalemic periodic paralysis Thyrotoxic periodic paralysis Refeeding: This is observed in prolonged starvation, eating disorders, and alcoholism Hypothermia (ref : harrisons principles of internal medicine, 19E, page 305)
Typo I Renal Tubular Acidosis ( A)
Type II A
Type IV A
Pencillin therapy
Fluid and electrolytes