Title (croatian) Jatrogena hiperkalijemija uzrokovana pogrešnim uzimanjem terapije - prikaz slučaja
Title (english) Iatrogenic Hyperkalemia Caused by Incorrect Medication Intake – a Case Report
Author Matko Spicijarić https://orcid.org/0000-0002-0117-1835
Author Vjekoslav Tomulić
Author's institution University of Rijeka Faculty of Medicine (Department of Internal Medicine)
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Internal Medicine
Abstract (croatian) Cilj: Hiperkalijemija je zbog svojih posljedica i pratećeg mortaliteta hitno stanje koje treba što ranije prepoznati i započeti s liječenjem. Ovaj rad ima za cilj prikazati dio dostupne dijagnostike i metode liječenja hiperkalijemije, ali i ukazati na nelogičnosti osiguravajućeg društva koje indirektno mogu dovesti do fatalnih posljedica za bolesnike. Prikaz slučaja: Bolesnik prikazan ovim radom pravovremeno je stigao u Objedinjeni hitni bolnički prijam gdje mu je zbog prisutne simptomatologije i nalaza elektrokardiograma postavljena sumnja na hiperkalijemiju. Navedeno je u kratkom vremenu potvrđeno uređajem point of care te je započeto liječenje. Incijalno se liječenje sastojalo od odgovarajuće medikamentozne terapije i transkutane elektrostimulacije, a zatim je postavljen privremeni elektrostimulator srca i provedena hitna dijaliza. Kasnije se heteroanamnestički doznalo da je bolesnik zabunom uzimao dvije vrećice kalijeva citrata ujutro i navečer, što je posljedično dovelo do jatrogene hiperkalijemije. Na otpusnom pismu, samo četiri dana pred navedeni događaj, uz preostalu terapiju naveden je nezaštićeni naziv lijeka Kalinora: kalijev citrat / kalijev hidrogenkarbonat 2/2 g 2 eff. i 1 eff. naizmjenično dnevno. Bolesnik je masu efervete protumačio kao propisanu jutarnju i večernju dozu, a liječnik obiteljske medicine prethodno je zamijenio propisanu formulaciju kalijevim citratom koji proizvodi JGL. Zaključak: Jatrogena hiperkalijemija jest rijetko stanje, ali kao i brojne druge komplikacije može nastati zbog pogrešnog uzimanja propisane terapije. Kako bi adherentnost bolesnika bila bolja, treba razmotriti uporabu zaštićenih naziva lijekova koji su bolesnicima razumljiviji. Liječnik obiteljske medicine ili ljekarnik svakako moraju propisati i izdati neki od zaštićenih oblika lijeka, stoga se nameće pitanje zašto to nije dopušteno bolničkom liječniku.
Abstract (english) Aim: Hyperkalemia, due to its consequences and accompanying mortality, is an emergency condition that should be recognized and treated as soon as possible. This paper aims to present some of the available diagnostics and treatment methods for hyperkalemia, but also to point out the illogicalities of the insurance fund, which can indirectly lead to fatal consequences for patients. Case report: The patient presented in this paper arrived in time at the Integrated Emergency Hospital Admission where, due to the present symptoms and electrocardiogram findings, hyperkalemia was suspected. The above was confirmed in a short time with the "point of care" device and the treatment was started. The initial treatment consisted of appropriate drug therapy and transcutaneous electrostimulation, then a temporary cardiac electrostimulator was placed and emergency dialysis was performed. Later, heteroanamnesis revealed that the patient mistakenly took two bags of potassium citrate in the morning and in the evening, which consequently led to iatrogenic hyperkalemia. On the discharge letter, just four days before the mentioned event, along with the remaining therapy, the generic name of the drug Kalinor was stated: potassium citrate / potassium hydrogen carbonate 2/2 g 2 eff. and 1 eff. alternately daily. The patient interpreted the effervescent mass as the prescribed morning and evening dose, and the general practitioner had previously replaced the prescribed formulation with potassium citrate produced by JGL. Conclusion: Iatrogenic hyperkalemia is a rare condition, but like many other complications, it can occur due to the incorrect use of the prescribed therapy. In order to improve patient adherence, the use of brand names of drugs that are more understandable to patients should be considered. A general practitioner or a pharmacist must certainly choose a brand medicine when prescribing and dispensing, and the question arises as to why this is not allowed for a hospital doctor.
Keywords (croatian)
aritmija srca
blok srca
hiperkalijemija
pogrešno uzimanje terapije
Keywords (english)
arrhythmias, cardiac
heart block
hyperkalemia
medication errors
Language croatian
Language english
Publication type Scientific paper - Case study
Publication status Published
Peer review Peer review
Publication version Published version
Journal title Medicina Fluminensis : Medicina Fluminensis
Numbering vol. 60, no. 2, pp. 224-228
p-ISSN 1847-6864
e-ISSN 1848-820X
DOI https://doi.org/10.21860/medflum2024_316202
URN:NBN urn:nbn:hr:184:088345
Publication 2024-06-01
Document URL https://hrcak.srce.hr/316202
Type of resource Text
Access conditions Open access
Terms of use
Created on 2024-06-06 07:25:53