Which drug is associated with hypokalemia in patients with cardiovascular disease?

Which drug is associated with hypokalemia in patients with cardiovascular disease?

• A. Furosemide
• B. Spironolactone
• C. ACE inhibitors like lisinopril
• D. Dobutamine

Answer: (D)

The effect to watch for is potassium loss due to how the drug acts in the kidney. Loop diuretics block sodium reabsorption in the thick ascending limb, which increases potassium secretion and excretion downstream, leading to hypokalemia. Spironolactone and ACE inhibitors tend to raise potassium levels because they reduce potassium loss (they’re potassium-sparing or promote less aldosterone effect). Dobutamine, an inotrope that boosts heart contraction via beta-1 stimulation, doesn’t cause a meaningful shift in potassium. So, in cardiovascular patients, hypokalemia is most classically tied to loop diuretics like furosemide, not to this inotrope.

The effect to watch for is potassium loss due to how the drug acts in the kidney. Loop diuretics block sodium reabsorption in the thick ascending limb, which increases potassium secretion and excretion downstream, leading to hypokalemia. Spironolactone and ACE inhibitors tend to raise potassium levels because they reduce potassium loss (they’re potassium-sparing or promote less aldosterone effect). Dobutamine, an inotrope that boosts heart contraction via beta-1 stimulation, doesn’t cause a meaningful shift in potassium. So, in cardiovascular patients, hypokalemia is most classically tied to loop diuretics like furosemide, not to this inotrope.