Therapeutic Uses and Side Effects
Fazal-I-Akbar Danish, Ahmed Ehsan Rabbani in Pharmacology in 7 Days for Medical Students, 2018
Due to abnormalities of fluid and electrolyte balance: ECF volume depletion (→ hypotension).Hyponatremia.Hypochloremia.Hypokalemia.Hypomagnesemia.Hypophosphatemia.Hypercalcemia (thiazide diuretics → all ‘hypos’ except hypercalcemia!).Decreased plasma level of halides.
Micronutrients
Chuong Pham-Huy, Bruno Pham Huy in Food and Lifestyle in Health and Disease, 2022
Chloride is an important component of diagnostic tests in different clinical situations. Hypochloremia is usually defined as serum chloride levels below 96–101 mmol/l, while hyperchloremia normally is defined as serum chloride levels higher than 106–111 mmol/l (15). Hypochloremia is often secondary to vomiting, diuretic therapy (furosemide, chlorothiazide), and renal disease. Excessive depletion of chloride ions through losses in the gastric secretions or by deficiencies in the diet may lead to alkalosis due to an excess of bicarbonate, since the inadequate level of chloride is partially compensated for or replaced by bicarbonate (8, 15). Chloride is excreted in the feces, sweat, and urine primarily as sodium or potassium chloride, and secondarily as ammonium chloride when the environment is alkaline (8).
Inhalant Abuse
John Brick in Handbook of the Medical Consequences of Alcohol and Drug Abuse, 2012
Chronic toluene abuse may cause metabolic acidosis with and without an anion gap (Taher et al., 1974). The elevated anion gap results from an accumulation of acidic metabolites, mainly hippuric and benzoic acid (Fischman and Oster, 1979). The electrolyte abnormalities include hypokalemia, hypochloremia, and hypophosphatemia. These electrolyte abnormalities occur due to the induction of a distal renal tubular acidosis by toluene (Fischman and Oster, 1979; Kamijo et al., 1998). The hypokalemia may be so great that patients suffer muscle weakness severe enough to cause rhabdomyolysis, paralysis, and respiratory failure (Kao et al., 2000). These metabolic abnormalities typically occur after chronic abuse of toluene. Complete recovery has been reported in patients during periods of avoidance (Taher et al., 1974). Severe hypokalemia and death associated with chronic toluene abuse have been reported (Kirk, Anderson, and Martin, 1984). Patients suffering the medical consequences of toluene abuse are often found in a severely weakened state with paint still on their faces and fingers.
Prevention and treatment of burn wound infections: the role of topical antimicrobials
Published in Expert Review of Anti-infective Therapy, 2022
Deepak K. Ozhathil, Steven E. Wolf
The most common adverse effect is disturbance electrolytes (hyponatremia and hypochloremia). This is due to silver ions binding to chlorine ions, causing silver salts to precipitate as brownish stain on the patient. As a result, patients treated with silver nitrate are always identifiable by this discoloration. Silver nitrate also has poor eschar penetration and requires repeat administration to maintain antimicrobial inhibition. Lastly, methemoglobinemia, due to the chemical reduction of nitrate compounds, is an infrequent complication [42]. Summary: Silver nitrate combined with nystatin is an excellent first line agent for post-operative topical antimicrobial therapy. It is effective against many common pathogens and has a negligible cytotoxic profile, even on split thickness skin grafts. However, it is ineffective against a number of microbial genera, so its use should be coupled with awareness of the wound microbiome. In addition, because it can precipitate electrolyte disturbances, caution should be used when used on patients with large TBSA burns and pre-existing conditions.
Treating potassium disturbances: kill the killers but avoid overkill
Published in Acta Clinica Belgica, 2019
R. Vanholder, W. Van Biesen, E. V. Nagler
The list of potential renal causes of hypokalemia is more extended than that of non-renal causes. Some of the major causes of renal hypokalemia are attributable to hypochloremia. Hypokalemia due to vomiting or gastric aspiration is mainly due to urinary excretion of potassium, which acts as a counter-ion for bicarbonate. The latter is excreted via the urine to correct the excess bicarbonate that is present in the serum as compensation for the chloride deficit. Renin angiotensin aldosterone system activation induced by dehydration further increases urinary potassium loss. Similar mechanisms are seen with diuretic-induced hypokalemia, and a few congenital disorders imposing renal Cl− losses (Gitelman and Bartter syndromes).
Thyroid gland involvement in secondary syphilis: a case report
Published in Acta Clinica Belgica, 2022
Thomas Strypens, Gudrun Alliet, Greet Roef, Linsey Winne
On laboratory testing, the white blood cell count was 19,500/µL with an absolute neutrophil count of 14,880/µL and a C-reactive protein (CRP) of 264.6 mg/L (Table 1). There was a slight hyponatremia and hypochloremia. The thyroid function tests showed an elevated free thyroxine (FT4) level with normal thyroid-stimulating hormone (TSH) and an elevated thyroglobulin (Table 1). Hemocultures were taken. An empirical antibiotic treatment with intravenous administration of 1-gram amoxicillin-clavulanic acid every 6 hours was started.
Related Knowledge Centers
- Alkalosis
- Chloride
- Respiratory Acidosis
- Vomiting
- Hyponatremia
- Hypoventilation
- Blood
- Electrolyte Imbalance