Medicina Fluminensis, Vol. 60 No. 2, 2024.
Case report, case study
https://doi.org/10.21860/medflum2024_316202
Iatrogenic Hyperkalemia Caused by Incorrect Medication Intake – a Case Report
Matko Spicijarić
orcid.org/0000-0002-0117-1835
; Klinički bolnički centar Rijeka, Klinika za bolesti srca i krvnih žila, Rijeka, Hrvatska; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
*
Vjekoslav Tomulić
orcid.org/0000-0002-3749-5559
; Klinički bolnički centar Rijeka, Klinika za bolesti srca i krvnih žila, Rijeka, Hrvatska; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
* Corresponding author.
Abstract
Aim: Hyperkalemia, due to its consequences and accompanying mortality, is an emergency condition that should be recognized and treated as soon as possible. This paper aims to present some of the available diagnostics and treatment methods for hyperkalemia, but also to point out the illogicalities of the insurance fund, which can indirectly lead to fatal consequences for patients. Case report: The patient presented in this paper arrived in time at the Integrated Emergency Hospital Admission where, due to the present symptoms and electrocardiogram findings, hyperkalemia was suspected. The above was confirmed in a short time with the "point of care" device and the treatment was started. The initial treatment consisted of appropriate drug therapy and transcutaneous electrostimulation, then a temporary cardiac electrostimulator was placed and emergency dialysis was performed. Later, heteroanamnesis revealed that the patient mistakenly took two bags of potassium citrate in the morning and in the evening, which consequently led to iatrogenic hyperkalemia. On the discharge letter, just four days before the mentioned event, along with the remaining therapy, the generic name of the drug Kalinor was stated: potassium citrate / potassium hydrogen carbonate 2/2 g 2 eff. and 1 eff. alternately daily. The patient interpreted the effervescent mass as the prescribed morning and evening dose, and the general practitioner had previously replaced the prescribed formulation with potassium citrate produced by JGL. Conclusion: Iatrogenic hyperkalemia is a rare condition, but like many other complications, it can occur due to the incorrect use of the prescribed therapy. In order to improve patient adherence, the use of brand names of drugs that are more understandable to patients should be considered. A general practitioner or a pharmacist must certainly choose a brand medicine when prescribing and dispensing, and the question arises as to why this is not allowed for a hospital doctor.
Keywords
arrhythmias, cardiac; heart block; hyperkalemia; medication errors
Hrčak ID:
316202
URI
Publication date:
1.6.2024.
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