Which electrolyte abnormality should be monitored in a patient taking an ACE inhibitor in combination with a potassium-sparing diuretic?

Which electrolyte abnormality should be monitored in a patient taking an ACE inhibitor in combination with a potassium-sparing diuretic?

• A. Hypokalemia
• B. Hyperkalemia
• C. Hyponatremia
• D. Hypercalcemia

Answer: (B)

Combining an ACE inhibitor with a potassium-sparing diuretic raises the risk of too much potassium in the blood. ACE inhibitors decrease aldosterone indirectly, and potassium-sparing diuretics either block aldosterone’s action or conserve potassium in the kidneys. The two together reduce potassium excretion, so hyperkalemia becomes the main concern. This can lead to muscle weakness and dangerous heart rhythm changes, so it’s essential to monitor potassium levels and kidney function after starting the therapy or adjusting doses. Advise patients to report symptoms like numbness, weakness, or palpitations, and avoid adding potassium-rich supplements or salt substitutes unless a clinician says it’s safe. Hyperkalemia is the key electrolyte issue to watch for with this drug combination.

Combining an ACE inhibitor with a potassium-sparing diuretic raises the risk of too much potassium in the blood. ACE inhibitors decrease aldosterone indirectly, and potassium-sparing diuretics either block aldosterone’s action or conserve potassium in the kidneys. The two together reduce potassium excretion, so hyperkalemia becomes the main concern. This can lead to muscle weakness and dangerous heart rhythm changes, so it’s essential to monitor potassium levels and kidney function after starting the therapy or adjusting doses. Advise patients to report symptoms like numbness, weakness, or palpitations, and avoid adding potassium-rich supplements or salt substitutes unless a clinician says it’s safe. Hyperkalemia is the key electrolyte issue to watch for with this drug combination.