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Electrolyte disturbances associated with commonly prescribed medications in the intensive care unit

Buckley, Mitchell S. PharmD; LeBlanc, Jaclyn M. PharmD; Cawley, Michael J. PharmD

doi: 10.1097/CCM.0b013e3181dda0be

Electrolyte imbalances are common in critically ill patients. Although multiple disease states typically encountered in the intensive care unit may be responsible for the development of electrolyte disorders, medications may contribute to these disturbances as well. Medications can interfere with the absorption of electrolytes, alter hormonal responses affecting homeostasis, as well as directly impact organ function responsible for maintaining electrolyte balance. The focus on this review is to identify commonly prescribed medications in the intensive care unit and potential electrolyte disturbances that may occur as a result of their use. This review will also discuss the postulated mechanisms associated with these drug-induced disorders. The specific drug-induced electrolyte disorders discussed in this review involve abnormalities in sodium, potassium, calcium, phosphate, and magnesium. Clinicians encountering electrolyte disturbances should be vigilant in monitoring the patient's medications as a potential etiology. Insight into these drug-induced disorders should allow the clinician to provide optimal medical management for the critically ill patient, thus improving overall healthcare outcomes.

From the Department of Pharmacy (MSB), Banner Good Samaritan Medical Center, Phoenix, AZ; Department of Pharmacy (JML), Saint John Regional Hospital, Saint John, NB, Canada; Philadelphia College of Pharmacy (MJC), University of the Sciences in Philadelphia, Philadelphia, PA.

The authors have not disclosed any potential conflicts of interest.

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© 2010 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins