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Poly-Citra K Crystals (citric acid / potassium citrate) Disease Interactions

There are 6 disease interactions with Poly-Citra K Crystals (citric acid / potassium citrate):

Major

Potassium Salts (Includes Poly-Citra K Crystals) ↔ Dehydration

Severe Potential Hazard, High plausibility

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

Potassium Salts (Includes Poly-Citra K Crystals) ↔ Familial Periodic Paralysis

Severe Potential Hazard, High plausibility

Applies to: Familial Periodic Paralysis

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 (Includes Poly-Citra K Crystals) ↔ Hyperkalemia

Severe Potential Hazard, High plausibility

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

Potassium Salts (Includes Poly-Citra K Crystals) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

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

Potassium Salts (Oral) (Includes Poly-Citra K Crystals) ↔ Gi Irritation

Severe Potential Hazard, High plausibility

Applies to: Gastrointestinal Obstruction, Peptic Ulcer, Gastrointestinal Hemorrhage, History - Peptic Ulcer, Duodenitis/Gastritis, Gastrointestinal Perforation, Esophageal Disease

The use of all solid oral formulations of potassium is contraindicated in patients with arrested or delayed gastrointestinal (GI) transit, whether due to structural, pathological, or pharmacological causes. Potassium is irritating to the GI mucosa and may cause ulcerative and/or stenotic lesions during prolonged physical contact. Based on spontaneous adverse reaction reports, the frequency of small bowel lesions associated with enteric-coated preparations of potassium chloride is 40 to 50 per 100,000 patient-years, while that for wax matrix controlled-release formulations is less than one per 100,000 patient years. Esophageal ulceration has also been reported following administration of controlled-release formulations of potassium chloride in cardiac patients with esophageal compression due to enlarged left atrium. Potassium supplementation should be administered as a liquid preparation or as an aqueous suspension in patients with esophageal obstruction and/or delayed gastrointestinal transit time.

Because of ulcerogenic effects, oral potassium should be administered cautiously in patients with peptic ulcers or other upper gastrointestinal diseases associated with inflammation, bleeding, or perforation. Patients should be advised not to crush, chew, or break potassium tablets or capsules, and to take them with meals and a full glass of water or other liquid. Potassium liquids should be diluted prior to consumption.

References

  1. Leijonmarck CE, Fenyo G, Raf L "Nontraumatic perforation of the small intestine." Acta Chir Scand 150 (1984): 405-11
  2. Davies DR, Brightmore T "Idiopathic and drug-induced ulceration of the small intestine." Br J Surg 57 (1970): 134-9
  3. "Small-intestine ulceration and enteric-coated potassium chloride." Med Lett Drugs Ther 7 (1965): 57-8
  4. "Potassium and gastrointestinal lesions. I." Nutr Rev 24 (1966): 138-41
  5. Delaney T, Hoxworth PI "Enteric-coated potassium chloride enteropathy." Surg Gynecol Obstet 127 (1968): 76-80
  6. Lech Y, Hey H, Jorgensen F, Matzen P, Ostergaard O "Evaluation of the ulcerogenic effect of potassium chloride by endoscopy and fecal blood loss." J Clin Pharmacol 27 (1987): 206-9
  7. McMahon FG, Ryan JR, Akdamar K, Ertan A "Upper gastrointestinal lesions after potassium chloride supplements: a controlled clinical trial." Lancet 2 (1982): 1059-61
  8. Jacobs E, Pringot J "Gastric ulcers due to the intake of potassium chloride." Am J Dig Dis 18 (1973): 289-94
  9. Dietz MW "Iatrogenic jejunal ulcer." Am J Roentgenol Radium Ther Nucl Med 99 (1967): 136-8
  10. Folk FS, Spellman MW, Hoffler OW "Stenosing small bowl ulceration. Apparently secondary to enteric- coated potassium chloride." J Natl Med Assoc 61 (1969): p315-8assim
  11. Barkin JS, Harary AM, Shamblen CE, Lasseter KC "Potassium chloride and gastrointestinal injury." Ann Intern Med 98 (1983): 261-2
  12. "Product Information. K-Dur (potassium chloride)." Schering Laboratories, Kenilworth, NJ.
  13. Naiken VS, Rachman R "Giant ulcers of the transverse colon." JAMA 217 (1971): 344
  14. Rosenthal T, Adar R, Militianu J, Deutsch V "Esophageal ulceration and oral potassium chloride ingestion." Chest 65 (1974): 463-5
  15. Javett S "Slow k ulcer." S Afr J Surg 13 (1975): 64
  16. McLoughlin JC "Gastrointestinal lesions and potassium chloride supplements." Lancet 1 (1985): 581-2
  17. "Potassium chloride and bowel ulceration." Br Med J 5475 (1965): 1383-4
  18. Mason SJ, O'Meara TF "Drug-induced esophagitis." J Clin Gastroenterol 3 (1981): 115-20
  19. Holland GW "Stenosing ulcers of the small bowel associated with thiazide and potassium therapy." N Z Med J 64 (1965): 383-5
  20. Ball JR "Letter: Potassium strictures of the upper alimentary tract." Lancet 1 (1976): 495-6
  21. Antonescu CG, Barritt AS 3d "Potassium chloride and gastric outlet obstruction." Ann Intern Med 111 (1989): 855-6
  22. Learmonth I, Weaver PC "Letter: Potassium stricture of the upper alimentary tract." Lancet 1 (1976): 251-2
  23. Leijonmarck CE, Raf L "Gastrointestinal lesions and potassium chloride supplements." Lancet 1 (1985): 56-7
  24. Watson MR, Mark JB "Ulceration of the small intestine. Relation to enteric-coated potassium." Am J Surg 112 (1966): 421-5
  25. Phillips BL "Potassium-induced bowel ulceration." Br J Clin Pract 28 (1974): 143-4
  26. Roberts HJ "Potassium chloride and intestinal ulceration." Lancet 2 (1965): 1127
  27. Skoutakis VA, Acchiardo SR, Wojciechowski NJ, Carter CA "Liquid and solid potassium chloride: bioavailability and safety." Pharmacotherapy 4 (1984): 392-7
  28. Lewis JH "Gastrointestinal injury due to medicinal agents." Am J Gastroenterol 81 (1986): 819-34
  29. McMahon FG, Ryan JR, Akdamar K, Ertan A "Effect of potassium chloride supplements on upper gastrointestinal mucosa." Clin Pharmacol Ther 35 (1984): 852-5
  30. Moore JG, Alsop WR, Freston JW, Tolman KG "The effect of oral potassium chloride on upper gastrointestinal mucosa in healthy subjects: healing of lesions despite continuing treatment." Gastrointest Endosc 32 (1986): 210-2
  31. Barloon TJ, Moore SA, Mitros FA "A case of stenotic obstruction of the jejunum secondary to slow- release potassium." Am J Gastroenterol 81 (1986): 192-4
  32. Lubbe WF, Cadogan ES, Kannemeyer AH "Oesophageal ulceration due to slow-release potassium in the presence of left atrial enlargement." N Z Med J 90 (1979): 377-9
  33. Teplick JG, Teplick SK, Ominsky SH, Haskin ME "Esophagitis caused by oral medication." Radiology 134 (1980): 23-5
  34. Sinar DR, Bozymski EM, Blackshear JL "Effects of oral potassium supplements on upper gastrointestinal mucosa: multicenter clinical comparison of three formulations and placebo." Clin Ther 8 (1986): 157-63
  35. Hasker W, McCaffrey J "Ulceration of a Meckel's diverticulum due to a potassium chloride tablet." Med J Aust 2 (1972): 261-2
  36. Trewby PN "Drug-induced peptic ulcer and upper gastrointestinal bleeding." Br J Hosp Med 23 (1980): 185-8,190
  37. Hartman SW, Greaney EM Jr, Rottapel D "Small-bowel ulceration due to enteric-coated potassium ingestion in a two-year-old child." Surgery 61 (1967): 814-5
  38. Collins FJ, Matthews HR, Baker SE, Strakova JM "Drug-induced oesophageal injury." Br Med J 1 (1979): 1673-6
  39. Shuster F, Berg EH "Enteric-coated potassium and bowel obstruction." JAMA 194 (1965): 570
  40. Moorhouse RA "Letter: Potassium-induced stricture of the small bowel." Lancet 1 (1976): 365
  41. Graham DY, Smith JL, Bouvet AA "What happens to tablets and capsules in the stomach: endoscopic comparison of disintegration and dispersion characteristics of two microencapsulated potassium formulations." J Pharm Sci 79 (1990): 420-4
  42. Ward C, Hamid S, Dow J "Gastric complication of massive Slow-K overdose." Br J Surg 74 (1987): 490
  43. Lawson DH "Adverse reactions to potassium chloride." Q J Med 43 (1974): 433-40
  44. Eng J, Sabanathan S "Drug-induced esophagitis." Am J Gastroenterol 86 (1991): 1127-33
  45. Farquharson-Roberts MA, Giddings AE, Nunn AJ "Perforation of small bowel due to slow release potassium chloride (slow-K)." Br Med J 3 (1975): 206
  46. Lambert JR, Newman A "Ulceration and stricture of the esophagus due to oral potassium chloride (slow release tablet) therapy." Am J Gastroenterol 73 (1980): 508-11
  47. Ashby WB, Humphreys J, Smith SJ "Small-bowel ulceration induced by potassium chloride." Br Med J 5475 (1965): 1409-12
  48. Raf LE "Enteric-coated potassium chloride tablets and ulcer of the small intestine." Acta Chir Scand Suppl 374 (1967): 32-50,73-74,76-77
  49. Watts CD, Curry C, Randolph RP "Intestinal complications found from potassium chloride. Case report." J Natl Med Assoc 57 (1965): 492-3
  50. Tresadern J, Rickwood AM, Spitz L "Multiple small bowel strictures in a child and accidental potassium chloride ingestion." Br Med J 2 (1977): 1124-5
  51. "Product Information. Kaon (potassium gluconate)." Savage Laboratories, Melville, NY.
  52. Bronson DL, Gamelli RL "Jejunal ulceration and stricture due to wax-matrix potassium chloride tablets and amitriptyline." J Clin Pharmacol 27 (1987): 788-9
  53. Sandor F "Complications of "slow-K" therapy." J R Coll Gen Pract 26 (1976): 595-8
  54. Berg EH, Schuster F, Segal GA "Thiazides with potassium producing intestinal stenosis." Arch Surg 91 (1965): 998-1001
  55. Riker J, Swanson M, Schweigert B "Esophageal ulceration caused by wax-matrix potassium chloride." West J Med 128 (1978): 542-3
  56. Brower RA "Jejunal perforation possibly induced by slow-release potassium in a patient with Crohn's disease." Dig Dis Sci 31 (1986): 1387-90
  57. Wagner W, Longerbeam JK, Smith LL, Feikes HL "Drug-induced ulcers of the small bowel causing intestinal obstruction or perforation." Am Surg 33 (1967): 7-11
  58. Lofgren RP, Rothe PR, Carlson GJ "Jejunal perforation associated with slow-release potassium chloride therapy." South Med J 75 (1982): 1154-5
  59. Moorhouse RA "Letter: Ulceration of small intestine and slow-release potassium tablets." Br Med J 3 (1975): 542
  60. Trechot P, Moore N, Bresler L, Castot A, Gay G, Netter P, Royer R "Potassium chloride tablets and small bowel stenoses and perforations: two studies in the french pharmacovigilance system." Am J Gastroenterol 89 (1994): 1268
  61. Wynn V "Potassium chloride and bowel ulceration." Br Med J 5477 (1965): 1546
  62. "Product Information. Urocit (potassium citrate)." Mission Pharmacal Company, San Antonio, TX.
  63. Strahan J, Sweeney PJ "A case of small bowel perforation." Ulster Med J 34 (1965): 22
  64. Billig DM, Jordan GL Jr "Nonspecific ulcers of the small intestine." Am J Surg 110 (1965): 745-9
  65. Reinus FZ, Weinberger HA, Fischer WW "Medication-induced ulceration of the small bowel." Am J Surg 112 (1966): 97-101
  66. Henry JG, Shinner JJ, Martino JH, Cimino LE "Fatal esophageal and bronchial artery ulceration caused by solid potassium chloride." Pediatr Cardiol 4 (1983): 251-2
  67. Leijonmarck CE, Raf L "Ulceration of the small intestine due to slow-release potassium chloride tablets." Acta Chir Scand 151 (1985): 273-8
  68. Weiss SM, Rutenberg HL, Paskin DL, Zaren HA "Gut lesions due to slow-release KCI tablets." N Engl J Med 296 (1977): 111-2
  69. Emerson DN "Potassium therapy and gastrointestinal lesions." Nebr State Med J 55 (1970): 518-23
  70. Lakhani M, Stewart WK "Hazards of potassium chloride solution." Lancet 2 (1985): 453
  71. Campbell JR, Knapp RW "Small bowel ulceration associated with thiazide and potassium therapy: review of 13 cases." Ann Surg 163 (1966): 291-6
  72. Strom BL, Carson JL, Schinnar R, Sim E, Maislin G, Soper K, Morse ML "Upper gastrointestinal tract bleeding from oral potassium chloride. Comparative risk from microencapsulated vs wax-matrix formulations." Arch Intern Med 147 (1987): 954-7
  73. Peters JL "Benign oesophageal stricture following oral potassium chloride therapy." Br J Surg 63 (1976): 698-9
View all 73 references
Moderate

Potassium Alkali Salts (Includes Poly-Citra K Crystals) ↔ Alkalosis

Moderate Potential Hazard, High plausibility

Applies to: Alkalosis

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

Poly-Citra K Crystals (citric acid / potassium citrate) drug Interactions

There are 562 drug interactions with Poly-Citra K Crystals (citric acid / potassium citrate)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
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 information available.

Do not stop taking any medications without consulting your healthcare provider.

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