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Citric acid / potassium bicarbonate Disease Interactions

There are 6 disease interactions with citric acid / potassium bicarbonate:

Major

Potassium salts (applies to citric acid/potassium bicarbonate) dehydration

Major Potential Hazard, High plausibility. Applicable conditions: Diarrhea

Administration of potassium salts in severe dehydration may predispose to renal impairment. Therapy with potassium salts should be administered cautiously in patients with acute dehydration (e.g., due to severe or prolonged diarrhea or heat stress). Close monitoring of serum potassium concentrations is recommended, as potentially fatal hyperkalemia can develop rapidly and is often asymptomatic, manifested only by an increased potassium level (6.5 to 8 mEq/L) and characteristic electrocardiographic changes (peaking of T waves, loss of P waves, depression of ST segment, prolongation of the QT interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest (9 to 12 mEq/L). Continuous or serial electrocardiography may be appropriate in some patients during replacement therapy, particularly if given intravenously.

References

  1. "Product Information. Potassium Acetate (potassium acetate)." Abbott Pharmaceutical, Abbott Park, IL.
  2. "Product Information. Kaon (potassium gluconate)." Savage Laboratories, Melville, NY.
  3. "Product Information. K-Dur (potassium chloride)." Schering Laboratories, Kenilworth, NJ.
  4. "Product Information. K-Lyte (potassium bicarbonate-potassium citrate)." Bristol-Myers Squibb, Princeton, NJ.
View all 4 references
Major

Potassium salts (applies to citric acid/potassium bicarbonate) familial periodic paralysis

Major Potential Hazard, High plausibility.

Administration of potassium salts may precipitate attacks in familial hyperkalemic periodic paralysis or paramyotonia congenita. Therapy with potassium preparations should be administered cautiously in patients with these conditions.

References

  1. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
Major

Potassium salts (applies to citric acid/potassium bicarbonate) hyperkalemia

Major Potential Hazard, High plausibility. Applicable conditions: Acidosis, Adrenal Insufficiency, Burns - External, Diabetes Mellitus, Hemolytic Anemia

The use of potassium salts is contraindicated in patients with hyperkalemia, since a further increase in serum potassium concentration in such patients can lead to cardiac arrhythmias or arrest. Potassium therapy should be administered cautiously in patients with conditions predisposing to hyperkalemia, such as chronic renal failure, systemic acidosis, acute dehydration, hypoaldosteronism (e.g., due to primary adrenal insufficiency or congenital adrenal enzyme deficiency), uncontrolled diabetes mellitus, and extensive tissue breakdown (e.g., due to severe burns, intravascular hemolysis, tumor lysis syndrome, or rhabdomyolysis). Close monitoring of serum potassium concentrations is recommended, as potentially fatal hyperkalemia can develop rapidly and is often asymptomatic, manifested only by an increased potassium level (6.5 to 8 mEq/L) and characteristic electrocardiographic changes (peaking of T waves, loss of P waves, depression of ST segment, prolongation of the QT interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest (9 to 12 mEq/L). Continuous or serial electrocardiography may be appropriate in some patients during replacement therapy, particularly if given intravenously.

References

  1. Perez GO, Oster JR, Pelleya R, Caralis PV, Kem DC "Hyperkalemia from single small oral doses of potassium chloride." Nephron 36 (1984): 270-1
  2. Saxena K "Death from potassium chloride overdose." Postgrad Med 84 (1988): 97-8,101-2
  3. Cox J, Starbuck M "Hyperkalemic cardiac arrest during an infusion of potassium chloride following an overdose of propranolol." Resuscitation 14 (1986): 255-6
  4. "Product Information. Urocit (potassium citrate)." Mission Pharmacal Company, San Antonio, TX.
  5. Illingworth RN, Proudfoot AT "Rapid poisoning with slow-release potassium." Br Med J 281 (1980): 485-6
  6. Ceuppens H, Hitchcock JF, Damen J, Jambroes G, Ae Dion R "Severe hypotension due to potassium-induced pericardial injury." Thorax 37 (1982): 546-7
  7. "Product Information. K-Lyte (potassium bicarbonate-potassium citrate)." Bristol-Myers Squibb, Princeton, NJ.
  8. Lawson DH "Clinical use of potassium supplements." Am J Hosp Pharm 32 (1975): 708-11
  9. Kopman EA, Ramirez-Inawat RC "Persistent electromechanical cardiac arrest following administration of cardioplegic and glucose-insulin-potassium solutions." Anesth Analg 59 (1980): 69-71
  10. "Product Information. K-Dur (potassium chloride)." Schering Laboratories, Kenilworth, NJ.
  11. Chakko SC, Frutchey J, Gheorghiade M "Life-threatening hyperkalemia in severe heart failure." Am Heart J 117 (1989): 1083-91
  12. Kallen RJ, Rieger CH, Cohen HS, Sutter MA, Ong RT "Near-fatal hyperkalemia due to ingestion of salt substitute by an infant." JAMA 235 (1976): 2125-6
  13. Schrier RW, Regal EM "Influence of aldosterone on sodium, water and potassium metabolism in chronic renal disease." Kidney Int 1 (1972): 156-68
  14. "Product Information. Kaon (potassium gluconate)." Savage Laboratories, Melville, NY.
  15. Lankton JW, Siler JN, Neigh JL "Letter: Hyperkalemia after administration of potassium from nonrigid parenteral-fluid containers." Anesthesiology 39 (1973): 660-1
  16. "Product Information. Potassium Acetate (potassium acetate)." Abbott Pharmaceutical, Abbott Park, IL.
  17. Wetli CV, Davis JH "Fatal hyperkalemia from accidental overdose of potassium chloride." JAMA 240 (1978): 1339
  18. Lawson DH "Adverse reactions to potassium chloride." Q J Med 43 (1974): 433-40
  19. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
View all 19 references
Major

Potassium salts (applies to citric acid/potassium bicarbonate) renal dysfunction

Major Potential Hazard, High plausibility.

The use of potassium salts is contraindicated in patients with severe renal impairment characterized by oliguria, anuria, or azotemia. Since potassium is excreted by the kidney, the administration of potassium salts in such patients, particularly by the intravenous route, may produce hyperkalemia and cardiac arrhythmias or arrest. Therapy with potassium salts should be administered cautiously in patients with diminished renal function or other conditions which impairs potassium excretion (e.g. adrenal insufficiency). Close monitoring of serum potassium concentrations is recommended, as potentially fatal hyperkalemia can develop rapidly and is often asymptomatic, manifested only by an increased potassium level (6.5 to 8 mEq/L) and characteristic electrocardiographic changes (peaking of T waves, loss of P waves, depression of ST segment, prolongation of the QT interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest (9 to 12 mEq/L). Continuous or serial electrocardiography may be appropriate in some patients during replacement therapy, particularly if given intravenously.

References

  1. "Product Information. K-Dur (potassium chloride)." Schering Laboratories, Kenilworth, NJ.
  2. "Product Information. Urocit (potassium citrate)." Mission Pharmacal Company, San Antonio, TX.
  3. "Product Information. Kaon (potassium gluconate)." Savage Laboratories, Melville, NY.
  4. "Product Information. Potassium Acetate (potassium acetate)." Abbott Pharmaceutical, Abbott Park, IL.
  5. "Product Information. K-Lyte (potassium bicarbonate-potassium citrate)." Bristol-Myers Squibb, Princeton, NJ.
View all 5 references
Moderate

Alkalinizing agents (applies to citric acid/potassium bicarbonate) acid/base balance

Moderate Potential Hazard, High plausibility. Applicable conditions: Renal Dysfunction

Alkalinizing agents act as proton acceptors and/or dissociate to provide bicarbonate ions. Elimination of bicarbonate is decreased in patients with renal impairment and can result in metabolic alkalosis. Symptoms of metabolic alkalosis include hyperirritability or tetany, arrhythmia, and/or seizures (altered pH = altered calcium), or lactic acidosis due to impaired oxygen release. Therapy with alkalinizing agents should be administered with extreme caution in patients with compromised renal function. Clinical monitoring of renal function, acid/base balance and electrolytes is recommended.

References

  1. "Product Information. Sodium Lactate (sodium lactate)." Abbott Pharmaceutical, Abbott Park, IL.
  2. "Product Information. Urocit (potassium citrate)." Mission Pharmacal Company, San Antonio, TX.
  3. "Product Information. Tham (tromethamine)." Abbott Pharmaceutical, Abbott Park, IL.
Moderate

Potassium alkali salts (applies to citric acid/potassium bicarbonate) alkalosis

Moderate Potential Hazard, High plausibility.

Hypokalemia in patients with metabolic or respiratory alkalosis should generally be treated with potassium chloride rather than an alkalinizing potassium salt (i.e. acetate, bicarbonate, citrate, or gluconate), since alkali therapy may exacerbate the condition. In addition, hypochloremia may accompany alkalosis, which is best treated with potassium chloride. Close monitoring of acid-base balance, serum electrolytes, electrocardiogram, and clinical status is recommended.

References

  1. "Product Information. K-Lyte (potassium bicarbonate-potassium citrate)." Bristol-Myers Squibb, Princeton, NJ.
  2. Walker WG, Jost LJ "Relative roles of patassium and chloride in correction of hypokalemic hypochloremic alkalosis." Johns Hopkins Med J 120 (1967): 148-54
  3. "Product Information. Potassium Acetate (potassium acetate)." Abbott Pharmaceutical, Abbott Park, IL.
  4. "Product Information. Kaon (potassium gluconate)." Savage Laboratories, Melville, NY.
View all 4 references

Citric acid / potassium bicarbonate drug interactions

There are 80 drug interactions with citric acid / potassium bicarbonate

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.