title: Hypokalemic Quadriparesis Secondary to Abuse of Cocaine and Heroin.
abstract: Low plasma potassium level can cause muscle weakness, lassitude, constipation as well as rhabdomyolysis and arrhythmias, when severe. In muscle, low plasma potassium increases resting membrane potential (hyperpolarization) of myocytes that tend to make muscle more refractory to excitation, leading to muscle weakness. Hypokalemia can be associated with a myriad of causes including drugs of abuse. We present a case of hypokalemia and muscle weakness following use of cocaine and heroin.
authors.affiliation: Internal Medicine Resident, Department of Medicine, Memorial Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Shrestha
authors.affiliation: Fellow, Division of Hematology and Oncology, Department of Internal Medicine, University of Nebraska Medical Center, Nebraska.
authors.forename: Vijaya Raj
authors.initials: VR
authors.lastname: Bhatt
authors.affiliation: Medical Student, Department of Medicine, Tribhuvan University Teaching Hospital, Tribhuvan University, Kathmandu, Nepal.
authors.forename: Ranjit Kumar
authors.initials: RK
authors.lastname: Chaudhary
authors.affiliation: Internal Medicine Resident, Department of Medicine, Memorial Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Rachana
authors.initials: R
authors.lastname: Sedhai
authors.affiliation: Clinical Assistant Professor of Medicine, Department of Medicine, Memorial Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Shiavax
authors.initials: S
authors.lastname: Cowasji
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology; D003042:Cocaine / Q000009:adverse effects*; D003248:Constipation / Q000209:etiology; D005260:Female; D003932:Heroin / Q000009:adverse effects*; D006801:Humans; D007008:Hypokalemia / Q000175:diagnosis* / Q000209:etiology; D018908:Muscle Weakness / Q000209:etiology; D011188:Potassium / Q000097:blood*; D011782:Quadriplegia / Q000209:etiology; D012206:Rhabdomyolysis / Q000209:etiology; D019966:Substance-Related Disorders / Q000150:complications*
chemical_list: D003932:Heroin; D003042:Cocaine; D011188:Potassium
keywords: cocaine; hypokalemia; muscle weakness; quadriparesis