Response of thiazide-induced hypokalemia to amiloride.
The effects of amiloride hydrochloride on thiazide-induced hypokalemia were evaluated. In metabolic balance studies, amiloride reversed thiazide-induced urinary potassium loss, restored plasma bicarbonate concentration and pH to pretreatment levels, and produced further increases in aldosterone secretion. Effects of long-term administration of hydrochlorothiazide and an amiloride-hydrochlorothiazide combination were compared in outpatients who had experienced thiazide-induced hypokalemia while receiving oral potassium supplements. After eight weeks, those given hydrochlorothiazide alone had an average serum potassium level of 3.01 +/- 0.08 mEq/L). Those given the amiloride-hydrochlorothiazide combination had an average serum potassium level of 3.75 +/- 0.008 mEq/L, not significantly different from the control value (3.82 +/- 0.08 mEq/L). Both groups had increased plasma aldosterone concentrations and plasma renin activity. The potassium-conserving effect of amiloride persisted with extended therapy.
D000450:Aldosterone / Q000097:blood; D000584:Amiloride / Q000008:administration & dosage* / Q000494:pharmacology; D001639:Bicarbonates / Q000097:blood; D004359:Drug Therapy, Combination; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage / Q000009:adverse effects*; D006973:Hypertension / Q000188:drug therapy*; D007008:Hypokalemia / Q000139:chemically induced / Q000517:prevention & control*; D011188:Potassium / Q000652:urine; D011719:Pyrazines / Q000008:administration & dosage*
D001639:Bicarbonates; D011719:Pyrazines; D006852:Hydrochlorothiazide; D000450:Aldosterone; D000584:Amiloride; D011188:Potassium