Early onset of hyperkalemia in patients treated with low molecular weight heparin: a prospective study

Koren‐Michowitz, Maya; Avni, Batia; Michowitz, Yoav; Moravski, Gil; Efrati, Shai; Golik, Ahuva

doi:10.1002/pds.881

Cited by 28 publications

(17 citation statements)

References 12 publications

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“…5 Some studies suggested increase in potassium levels when treated with LMWH which was not seen in our studies. 6 LMWH accounted for highest cost incase of anticoagulants. It was used in patients with Ischemic Heart Disease (IHD), cardiovascular accident, hyper obstructive cardiomyopathy, femur fracture, cerebrovascular accident, Peripheral Artery Disease, PE, DVT, PE-DVT.…”

Section: • Warfarin 5mentioning

confidence: 99%

Anticoagulant Utilization Evaluation in a Tertiary Care Teaching Hospital: An Observational Prospective Study in Medical in Patients

Singh¹,

M.²,

Behzadpour³

et al. 2015

IJOPP

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Introduction: Drug utilization evaluation of anticoagulant drugs is essential considering the spectrum of use and associated risks with their therapy. Objectives: The objectives of the present study were to evaluate the drug utilization pattern of anticoagulants, identify and assess drug interactions and ADRs with the use of anticoagulants. Method: 84 patients from the medicine department were included in this prospective, cross sectional study conducted for one year. Results: Heparin was mainly used for prophylaxis. Enoxaparin and acenocoumarol were other commonly used drugs. The diagnosis varied from Ischemic heart disease (IHD), deepvein thrombosis (DVT), pulmonary embolism (PE), cardiovascular accident and others. Laboratory tests like prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), in few cases radiological tests were performed to monitor the therapy. Use of mono therapy and combination therapy aswell as topical use of heparingel was observed. Acenocoumarol and warfarin were the drugs prescribed at discharge. 35 drug interactions were identified, twelve pharmacokinetic and twenty three pharmaco dynamic in nature. Acenocoumarol was the most commonly identified drug with drug interactions. Pharmacokinetic mechanism commonly found was inhibition of vitamin Kactivity; synergistic effect was the mechanism of pharmaco dynamic interaction. Sixteen interactions were severe in intensity.6 adverse drug reactions (ADRs) were observed during the study. Conclusion:The pharmacotherapy with anticoagulant drugs should be cost effective and with minimum risks involved. The study highlights the importance of following the guidelines for appropriate use of anticoagulants.

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Section: • Warfarin 5mentioning

confidence: 99%

Anticoagulant Utilization Evaluation in a Tertiary Care Teaching Hospital: An Observational Prospective Study in Medical in Patients

Singh¹,

M.²,

Behzadpour³

et al. 2015

IJOPP

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“…Heparin can cause hyperkalemia by blocking adrenal gland biosynthesis of aldosterone. This effect occurs quickly (in a matter of several days), at low doses of heparin (IV or subcutaneously), and has been described with low‐molecular‐weight heparin as well 33–34 . Refractory hyperkalemia can also be seen in conjunction with digitalis intoxication 35 .…”

Section: Concomitant Medications/conditionsmentioning

confidence: 97%

Aldosterone Receptor Antagonism: Interface With Hyperkalemia in Heart Failure

Sica

Heß

2004

Congestive Heart Failure

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Aldosterone receptor antagonism (ARA) is an increasingly well-accepted element of heart failure therapy. The experimental underpinnings for the use of ARA in heart failure are strong being linked to a variety of tissue-based cardiac effects characteristic of drugs in this class. However, the benefits of ARA therapy do not come without some risk since drugs in this class are potent inhibitors of renal potassium (K+) elimination. Thus, some increment in serum K+, up to and including the development of overt hyperkalemia (typically defined as a serum K+ value in excess of 6.0 mEq/L), is to be expected whenever they are used. Hyperkalemia attributable to ARA relates to several factors including ARA dose, patient predisposition to hyperkalemia, as in the case of renal failure, and dietary intake of K+. The risk of some change in serum K+ with ARA should not be a deterrent to use of drugs in this class but, rather should prompt careful surveillance for the onset of this potentially life-threatening electrolyte disturbance. The frequency of such scrutiny should be patient-specific and based on the constellation of risk factors for hyperkalemia.

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“…Devant un hypoaldostéronisme, il faut toujours chercher une origine iatrogène, certains médicaments exerçant une action rémanente après leur interruption (encadré 2) [31,32]. Toutefois certaines de ces thérapeutiques favorisent plutôt l'hypertension (fludrocortisone, cortisone, GH).…”

Section: Hypoaldostéronismes D'origine Iatrogèneunclassified

Hypotensions d’origine endocrinienne

2012

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Early onset of hyperkalemia in patients treated with low molecular weight heparin: a prospective study

Abstract: Potassium levels increase on the third day of treatment with the LMWH Enoxaparin. This effect may be aldosterone independent.

Cited by 28 publications

References 12 publications

Anticoagulant Utilization Evaluation in a Tertiary Care Teaching Hospital: An Observational Prospective Study in Medical in Patients

Anticoagulant Utilization Evaluation in a Tertiary Care Teaching Hospital: An Observational Prospective Study in Medical in Patients

Aldosterone Receptor Antagonism: Interface With Hyperkalemia in Heart Failure

Hypotensions d’origine endocrinienne

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