A patient with severe chronic kidney disease complains of an episode of syncope. Her 12-lead EKG shows widening of the QRS complex and peaking of T waves. Her medications include amlodipine (a calcium channel blocker), lisinopril (an ACE inhibitor), potassium chloride, glyburide (for diabetes mellitus), and tiotropium (for chronic obstructive pulmonary disease). Which of these medications may be responsible for her signs and symptoms?

Question

Quizplus · Accepted Answer

Patients with chronic kidney disease do not excrete potassium normally and often develop hyperkalemia. This patient is taking potassium chloride, and an angiotensin-converting enzyme (ACE) inhibitor, both of which may exacerbate her tendency to have a high serum potassium level.

A Patient with Severe Chronic Kidney Disease Complains of an Episode