Life-threatening hyperkalemia after intravenous labetolol injection for hypertensive emergency in a hemodialysis patient.
Intravenous labetolol, a nonselective alpha- and beta-blocking drug, is commonly used to treat severe hypertension. Nonselective beta-blockers can cause hyperkalemia, especially in patients with renal failure. One series reported 3 renal transplant patients who had hyperkalemia after labetolol infusion, but none of these patients developed any serious complication. We report a case of life-threatening hyperkalemia (serum [K+] 9.9 mEq/l) with ventricular tachycardia and hypotension in a patient on maintenance hemodialysis who received labetolol for a hypertensive emergency. Physicians should be aware of this potentially lethal complication, which is easily preventable.
Hamad
A
A
Department of Medicine, Nassau University Medical Center and State University of New York at Stony Brook, East Meadow, NY, USA.
Salameh
M
M
Zihlif
M
M
Feinfeld
D A
DA
Carvounis
C P
CP
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D000328:Adult; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced*; D006974:Hypertension, Malignant / Q000188:drug therapy*; D007275:Injections, Intravenous; D007676:Kidney Failure, Chronic / Q000628:therapy*; D007741:Labetalol / Q000009:adverse effects* / Q000627:therapeutic use*; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects*
D000319:Adrenergic beta-Antagonists; D007741:Labetalol