Hypokalemia caused by levothyroxine sodium
10.3760/cma.j.cn114015-20220812-00742
- VernacularTitle:左甲状腺素钠致低钾血症
- Author:
Wenjuan YANG
1
;
Zhe SUN
;
Canyu YANG
;
Fang LIU
Author Information
1. 浙江省立同德医院药学部，杭州 310012
- Publication Type:Journal Article
- Keywords:
Hypothyroidism;
Thyroxine;
Hypokalemia
- From:
Adverse Drug Reactions Journal
2023;25(4):253-254
- CountryChina
- Language:Chinese
-
Abstract:
An 85-year-old male patient received left thyroxine sodium (LT4) 50 μg orally once daily for replacement therapy because of ischemic stroke and hypothyroidism. Next day, laboratory test showed that blood potassium was 3.0 mmol/L. He was given potassium chloride sustained-release tablets 1 g orally thrice daily. Six days later, the patient complained of a rapid heartbeat after slight activity. Laboratory tests showed that blood potassium was 3.3 mmol/L and a potassium magnesium aspartate tablet was administered orally thrice daily. After 8 days of potassium supplementation treatments, the patient's blood potassium level was 3.5 mmol/L, while the blood pressure increased to 163/90 mmHg. Losartan potassium 50 mg once daily was given orally. Clinical pharmacist consulted and learned that the patient continued to take his own LT4 75 μg once daily while following the doctor's instructions to take LT4 50 μg once daily. The patient was instructed to immediately stop taking his own medication and the LT4 dose was adjusted to 75 μg once daily. Thirteen days later, the patient's serum potassium returned to 4.0 mmol/L and no further discomfort occurred.
