Case scenarios

Gavin, 45, is admitted to your hospital for elective surgery on his anterior cruciate ligament (ACL) after rupturing it playing soccer. He is otherwise fit and well, apart from mild hypertension, for which he takes irbesartan with hydrochlorothiazide 150/25 mg daily. Routine blood tests taken at the time of surgery (12 hours ago now) reveal a serum potassium of 3.1 mmol/L (mild hypokalaemia).

Grace, 75, is admitted to hospital with rapid atrial fibrillation (heart rate is 130 bpm), signs of confusion and an infective exacerbation of COPD. She has a history of stage 1 (mild) chronic kidney disease, pulmonary hypertension and subsequent right-sided heart failure secondary to COPD. She takes furosemide 40 mg twice daily, irbesartan 150 mg daily and an indacaterol 110 mcg plus glycopyrronium 50 mcg inhaler, 1 dose daily. A blood test on admission reveals a serum potassium of 3.3 mmol/L (mild hypokalaemia).

Learning Objectives

After reading this article, pharmacists should be able to:

  • Describe the effects of potassium and magnesium concentration disturbances
  • List causes of potassium and magnesium concentration disturbances
  • Discuss how potassium and magnesium concentration disturbances are treated.

Competency standards (2016) addressed: 1.1, 1.3, 1.4, 1.5, 3.1, 3.2, 3.3, 3.5

Accreditation number: CAP2407AMKW

Accreditation expiry: 30/06/2027

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