Hyper/Hypo

Question 1

hyperkalemia s/s

Answer 1

Muscle weakness
Muscular irritability (early)
Cramps or flaccid paralysis (late)
N&V, Confusion
Arrhythmias
Ventricular fibrillation or asystole
Heart block
Cardiac arrest

Question 2

Digitalis causes

Answer 2

Hypercalcemia
Hypomagnesaemia
Hypokalemia
(which can precipitate a toxic reaction w/AN, N&V, cramps, arrhythmias, paresthesia, confusion)

Question 3

Hypokalemia increases risk of

Answer 3

Digitalis toxicity

Question 4

Herbs that cause K loss w/digitalis glycosides

Answer 4

Aloe latex
Drug aloe
Buckthorn bark & berry
Cassava sagrada bark
Sienna leaf

Question 5

licorice + digitalis =

Answer 5

Na & water retention, hypertension, hypokalemia

Question 6

ACE inhibitors: potassium

Answer 6

decreases K excretion, causes hyperkalemia. monitor K levels, avoid high K foods, K sup, and salt substitutes.

Question 7

digoxin increase secretion of

Answer 7

calcium, magnesium, zinc

Question 8

ACE inhibitors + pomegranate juice =

Answer 8

hypotension

Question 9

ACE Inhibitor (captopril)

Answer 9

long term use may cause zinc depletion

Question 10

hypoalbuminemia + warfarin =

Answer 10

increase action of warfarin & risk of bleeding

Question 11

CHF pt, Lasix: thiamin

Answer 11

in pts w/CHF, Lasix increases thiamin excretion & depletion which worsens heart fcn. rec thiamin sup.

Question 12

Lasix: sodium

Answer 12

Lasix reduces kidney’s ability to reabsorb Na, more gets excreted

Question 13

Lasix: electrolytes

Answer 13

enhanced sodium, chloride, calcium, potassium, magnesium, and water excretion

Question 14

beta blockers: K

Answer 14

hyperkalemia

Question 15

beta blockers: implications

Answer 15

hyperlipidemia.

hyperglycemia or mask signs of hypoglycemia.

Question 16

K sparing diuretics: K

Answer 16

hyperkalemia (risk is increased in DM, renal failure, elderly, ACE inhibitors). avoid sups, salt subst, high K intake.

Question 17

hyperaldosteronism Tx

Answer 17

Spironolactone (aldactone) (K sparing diuretic).

Question 18

K wasting diuretics: monitor

Answer 18

serum electrolytes & water. increased excretion of water, sodium, chloride, potassium, magnesium

Question 19

K wasting diuretics: Na

Answer 19

careful w/hyponatremia and dehydration in heat or sweating exercise

Question 20

hypokalemia is less likely in pts w/

Answer 20

renal failure, taking K sparing diuretic, or ACE inhibitors

Question 21

hyperkalemia is more likely in pts who are

Answer 21

elderly, diabetic, renal failure, or taking ACE inhibitors

Question 22

adjunctive therapy for hypercalcemia

Answer 22

glucocorticoids (all end in -sone, -solone) {antibiotic}

Question 23

increased side effects from glucocorticoids at

Answer 23

high dosages and in pts w/hypoalbuminemia

Question 24

Glucocorticoids: hyper/hypos

Answer 24

• Hypocalcemia and osteomalacia due to anti vitamin D activity. Recommend Ca supp
• Protein catabolism
• Hyperlipidemia
• Hyperphagia & weight gain
• Hyperglycemia

Question 25

Fluoroquinolones {antibiotic}: minerals

Answer 25

Reduced absorption of both the med and minerals: calcium, magnesium, iron, and aluminum that will form chelates with fluoroquinolones

Question 26

Theophylline {bronchodilator/xanthine asthma med}

Answer 26

increase excretion of potassium & magnesium

Question 27

Methotrexate (Folex): folate

Answer 27

folate antagonist, may cause folate def.

Question 28

hyperuricemia

Answer 28

due to methotrexate. rec high fluid intake to prevent kidney stones.

Question 29

PPI’s: B-12

Answer 29

decrease absorption of food sources of B-12, but not supplement sources.

Question 30

PPI’s: reduced stomach acidity

Answer 30

decreased absorption in: magnesium, calcium, iron, thiamin. risk of hypomagnesemia

Question 31

PPI’s: vit D

Answer 31

decrease vit D activation, risk of osteoporosis

Question 32

cyclosplorine {immunosuppressant}: electrolytes

Answer 32

hypomagnesemia

hyperkalemia

Question 33

cyclosplorine {immunosuppressant}: may cause

Answer 33

hyperlipidemia
↑BG
hyperuricemia

Question 34

Cyclosporine (neoral, sandimmune): hyper/hypo

Answer 34

• hypomagnesemia and hyperkalemia.

* hyperlipidemia, ↑BG, and hyperuricemia.

Question 35

Antacids may decrease absorption of

Answer 35

phosphorus, iron, thiamin, vit A

Question 36

PPI’s & Hist blockers may

Answer 36

decrease absorption of vit B-12

Question 37

lower stomach acid may

Answer 37

decrease absorption of calcium, magnesium, iron