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Select whether the following drugs carry a risk of causing hyperkalemia or hypokalemia:

A.

Losartan

B.

Furosemide

C.

Spironolactone

D.

Lisinopril

E.

Digoxin

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"}}

  • Losartan: As an angiotensin II receptor blocker (ARB), losartan reduces aldosterone secretion, leading to decreased potassium excretion and potential hyperkalemia, especially in patients with renal impairment or those on potassium supplements.
  • Furosemide: This loop diuretic promotes the excretion of sodium and potassium in the urine, commonly resulting in hypokalemia. Patients on furosemide often require potassium monitoring or supplementation.
  • Spironolactone: A potassium-sparing diuretic and aldosterone antagonist, spironolactone reduces potassium excretion in the distal nephron. This can lead to hyperkalemia, particularly when used with other potassium-elevating drugs.
  • Lisinopril: An ACE inhibitor that blocks the conversion of angiotensin I to II, reducing aldosterone levels and thereby decreasing potassium excretion. This places patients at risk for hyperkalemia.
  • Digoxin: This cardiac glycoside may cause hypokalemia indirectly by increasing sensitivity to potassium shifts. Additionally, low potassium levels enhance digoxin toxicity, so maintaining normal potassium is critical during therapy.


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Related Questions

Correct Answer is A

Explanation

A. "All antipsychotic drugs carry an equal risk of causing movement-related side effects.": First-generation antipsychotics like Haloperidol are more likely to cause extrapyramidal symptoms due to their potent dopamine D2 receptor blockade. Second-generation antipsychotics carry a lower risk, making this statement inconsistent with clinical evidence.
B. "These side effects happen because this drug blocks dopamine in certain parts of my brain.": Extrapyramidal symptoms are primarily due to dopamine blockade in the nigrostriatal pathway, which regulates motor control. Interference in this region leads to tremors, rigidity, and other movement disorders.
C. "Taking other drugs with my Haloperidol can increase the risk of extrapyramidal symptoms.": Concurrent use of medications that also affect dopamine pathways or have sedative effects can increase the likelihood of developing EPS. Drug interactions are a significant factor in overall risk.
D. "Tardive dyskinesia occurs with prolonged use of an antipsychotic drug.": Long-term use of dopamine-blocking agents, especially at high doses, can lead to tardive dyskinesia. This condition involves involuntary movements and may be irreversible, particularly in older adults.

Correct Answer is D

Explanation

A. Respiratory arrest and coma: These are late, life-threatening manifestations of local anesthetic systemic toxicity (LAST) that occur after CNS and cardiovascular collapse. Recognizing early signs is critical to preventing progression to this severe stage.
B. Ventricular arrhythmias and cardiac arrest: These are also late signs of LAST, resulting from the anesthetic’s depressant effects on cardiac conduction. By the time these occur, toxicity is advanced and may require immediate resuscitation measures.
C. Hypotension and tachycardia: Although cardiovascular symptoms may eventually develop, they are typically preceded by neurological signs. Early identification and management of CNS symptoms can often prevent progression to cardiovascular compromise.
D. Tinnitus, metallic taste, and perioral numbness: These are classic early signs of LAST and indicate CNS involvement. They often occur within minutes of administration and should prompt immediate intervention to stop drug absorption and initiate supportive care.

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