A 78-year-old female patient with type 2 diabetes for 30 years, hypertension for more than 10 years, diabetes nephropathy for 4 years, and renal anemia for several years additionally received roxadustat (70 mg thrice per week orally) for anemia. After 5 days, the patient developed sudden chest tightness, asthma, acute left heart failure, and depressed edema of both lower limbs. The electrocardiogram showed sinus arrest, escape rhythm, and a heart rate of 40 beats per minute. Laboratory test results showed blood pH 7.31, blood potassium 5.3 mmol/L, blood creatinine 304 μmol/L, B-type natriuretic peptide 1 280.0 ng/L, high-sensitivity troponin T 0.042 μg/L, and creatine kinase MB 0.83 μg/L. Acute left heart failure, hyperkalemia, and metabolic acidosis caused by roxadustat were considered. Roxadustat and other long-term oral medication such as hypoglycemic and antihypertensive drugs were discontinued. Symptomatic treatments such as sodium bicarbonate, insulin, furosemide, calcium gluconate, and blood filtration were given. Two days later,the patient′s heart rate and blood potassium returned to normal; 7 days later, the patient′s B-type natriuretic peptide was 168.0 ng/L, blood creatinine was 170 μmol/L, and blood potassium was 4.13 mmol/L. The patient had no chest tightness or asthma, and no edema in both lower limbs. Long-term oral medication such as hypoglycemic and antihypertensive drugs were given again. At a 1 month follow-up, the patient did not experience chest tightness or asthma, and the electrolyte levels were normal.

A 78-year-old female patient with type 2 diabetes for 30 years, hypertension for more than 10 years, diabetes nephropathy for 4 years, and renal anemia for several years additionally received roxadustat (70 mg thrice per week orally) for anemia. After 5 days, the patient developed sudden chest tightness, asthma, acute left heart failure, and depressed edema of both lower limbs. The electrocardiogram showed sinus arrest, escape rhythm, and a heart rate of 40 beats per minute. Laboratory test results showed blood pH 7.31, blood potassium 5.3 mmol/L, blood creatinine 304 μmol/L, B-type natriuretic peptide 1 280.0 ng/L, high-sensitivity troponin T 0.042 μg/L, and creatine kinase MB 0.83 μg/L. Acute left heart failure, hyperkalemia, and metabolic acidosis caused by roxadustat were considered. Roxadustat and other long-term oral medication such as hypoglycemic and antihypertensive drugs were discontinued. Symptomatic treatments such as sodium bicarbonate, insulin, furosemide, calcium gluconate, and blood filtration were given. Two days later,the patient′s heart rate and blood potassium returned to normal; 7 days later, the patient′s B-type natriuretic peptide was 168.0 ng/L, blood creatinine was 170 μmol/L, and blood potassium was 4.13 mmol/L. The patient had no chest tightness or asthma, and no edema in both lower limbs. Long-term oral medication such as hypoglycemic and antihypertensive drugs were given again. At a 1 month follow-up, the patient did not experience chest tightness or asthma, and the electrolyte levels were normal.

OBJECTIVE:To prepare Potassium dehydroandrographolide succinate(PDS)hollow suppository and establish a method for its quality control.METHODS:The PDS hollow suppository was prepared with semisynthesis fatty acid glyceride as ground substances and PEG300 or 1,2 propylene glycol as disperse medium.The content of PDS was determined by ultraviolet spectrophotometry at a detection wavelength of 251nm.RESULTS:The linear concentration range of PDS was 6.0～50.0?g?mL-1(r=0.999 9,n=5).The two kinds of PDS hollow suppository were all up to the quality standard.CONCLUSION:This method is reasonable in design and feasible in technology.