A patient with recurrent angina and hypertension has an admission order for spironolactone daily and a potassium supplement listed. Which prescription should be questioned immediately?

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Multiple Choice

A patient with recurrent angina and hypertension has an admission order for spironolactone daily and a potassium supplement listed. Which prescription should be questioned immediately?

Managing potassium levels is crucial when a patient is on spironolactone, a potassium-sparing diuretic. Spironolactone blocks aldosterone, which reduces potassium excretion by the kidneys. Adding a potassium supplement while on this drug pushes potassium upward, increasing the risk of hyperkalemia. Hyperkalemia can cause muscle weakness, ECG changes, and potentially life-threatening arrhythmias, so the prescription for potassium should be questioned immediately to prevent dangerous levels. The other orders don’t carry the same immediate risk. A 2 gram sodium diet supports blood pressure and heart health. Metoprolol and diltiazem are common antihypertensive/anti-anginal agents and don’t inherently raise potassium, so they don’t pose the same urgent concern in this context. If potassium supplementation is kept, it would require careful monitoring of serum potassium and renal function and possible adjustment of spironolactone.

Managing potassium levels is crucial when a patient is on spironolactone, a potassium-sparing diuretic. Spironolactone blocks aldosterone, which reduces potassium excretion by the kidneys. Adding a potassium supplement while on this drug pushes potassium upward, increasing the risk of hyperkalemia. Hyperkalemia can cause muscle weakness, ECG changes, and potentially life-threatening arrhythmias, so the prescription for potassium should be questioned immediately to prevent dangerous levels.

The other orders don’t carry the same immediate risk. A 2 gram sodium diet supports blood pressure and heart health. Metoprolol and diltiazem are common antihypertensive/anti-anginal agents and don’t inherently raise potassium, so they don’t pose the same urgent concern in this context. If potassium supplementation is kept, it would require careful monitoring of serum potassium and renal function and possible adjustment of spironolactone.

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