(ATN) TMP-SMX: High Treatment Dose Can Cause Hyperkalemia

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(ATN) TMP-SMX: High Treatment Dose Can Cause Hyperkalemia

AIDS TREATMENT NEWS Issue #183, September 17, 1993
John S. James


A study by physicians at the Brookdale Hospital Medical Center in Brooklyn, New York, measured serum potassium levels in 25 patients who were given high-dose TMP-SMX for treatment of pneumocystis, compared with 26 patients not given that drug. They concluded that high-dose TMP-SMX could result in life-threatening hyperkalemia, particularly 7 to 10 days after the start of treatment, and that serum potassium levels should be monitored closely. (Note: this study looked at the high doses used to treat pneumocystis -- not the much lower doses used for prophylaxis.)

[Greenberg S, Reiser IW, Chou SY, and Porush JG. Trimethoprim-sulfamethoxazole induces reversible hyperkalemia. ANNALS OF INTERNAL MEDICINE. August 15, 1993; volume 119, number 4, pages 291-295. The following article starting on page 296, by different authors, looks at a possible cause, involving effects of the drug on the kidney.]


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