Moguće interakcije s lijekovima

Ako koristite bilo koji od dolje navedenih lijekova/pripravaka, ne preporuča se da uzimate dodatne mineralne pripravke s kalijem bez dozvole liječnika.

ACE Inhibitori – ACE inhibitori, tj. inhibitori angiotenzin konvertirajućeg enzima, su lijekovi koji se koriste u liječenju hipertenzije i kongestivnog zatajenja srca. Istraživanja pokazuju da mogu povećavati razine kalija u krvi. Uključuju lijekove kao što su kaptopril i enalapril, benazepril, lisinopril, moeksipril, kvinapril, ramipril i dr.[1-5]

Aminoglikozidi – Aminoglikozidi mogu uzrokovati oštećenje bubrega te time uzrokovati i hipokalemiju Točnije, mogu povećati urinarno izlučivanje ovog minerala, a uključuju antibiotike kao što su gentamicin i tobramicin.[6-10]

Antagonisti receptora angiotenzina II – Ovi lijekovi, kao što su losartan, valsartan, irbesartan i kandesartan, mogu uzrokovati značajno povećanje razina kalija u krvi.[11-13]

Antihipertenzivi – Antihipertenzivi kao što su beta blokatori, a uključuju atenolol, acebutolol, betaksolol, metoprolol, sotalol, bisoprolol, propranolol, labetalol, nadolol i dr., mogu uzrokovati hiperkalemiju tako što smanjuju njegov ulazak u stanice čime se povećava njegova koncentracija u krvi. Međutim, blokatori kalcijevih kanala, kao što je felodipin, mogu povećati izlučivanje kalija, što može rezultirati hipokalemijom.[14-18]

Bronhodilatatori i beta-adrenergički agonisti – Ovi lijekovi, kao što su teofilin, albuterol, terbutaline, epinefrin, dobutamin i izoproterenol, mogu uzrokovati nedostatak kalija, odnosno, hipokalemiju.[19-28]

Cisplatin – Cisplatin je lijek koji se koristi u kemoterapiji, a može pojačati urinarno izlučivanje kalija.[29-32]

Digoksin – Digoksin, koji se često rabi za liječenje raznih bolesti srca, može uzrokovati pogoršanja u prijenosu kalija iz krvi u stanice, što može rezultirati hiperkalemijom. Međutim, obično se uzima s diureticima, koji mogu uzrokovati hipokalemiju, a koja može pogodovati toksičnosti ovog lijeka.[33-35]

Diuretici koji štede kalij – Ovi lijekovi, kao što je amilorid, spironolakton i triamteren, smanjuju urinarno izlučivanje kalija, što može rezultirati nakupljanjem kalija u organizmu, tj. hiperkalemijom.[36-41]

Diuretici koji ne štede kalij (diuretici Henleove petlje i tiazidni diuretici) – Ovi diuretici, kao što su furosemid, klortiazid i hidroklortiazid, povećavaju urinarno izlučivanje kalija te mogu uzrokovati hipokalemiju.[42-46]

Laksativi – Laksativi, kao što su dokuzat i bisakodil, mogu uzrokovati neodstatak kalija i povećati njegovo izlučivanje fecesom, dok mineralna ulja mogu ometati apsorpciju kalija.[47-50]

Haloperidol – Ovaj antagonist dopamina, koji se koristi u liječenju psihotičnih poremećaja, može uzrokovati poremećaje u homeostazi kalija, tj. može uzrokovati i hiperkalemiju i hipokalemiju.[51-53]

Heparin – Heparin, antikoagulans, može uzrokovati hiperkalemiju.[11,54,55]

Kotrimoksazol (sulfametoksazol i trimetoprim) – Ova kombinacija antiobiotika može uzrokovati povećanje razina kalija u krvi, zbog ometanja urinarnog izlučivanja ovog minerala.[11,56-61]

Nesteroidni protuupalni lijekovi – Ovi lijekovi, kao što je ibuprofen, indometacin, ketorolak, etodolak, nabumeton, naproksen, oksaprozin i sulindak, mogu uzrokovati oštećenje bubrega i povećati razine kalija u krvi, posebno u starijih osoba. Međutim, salsalati, koji se u tijelu metaboliziraju u salicilnu kiselinu, mogu uzrokovati hipokalemiju (npr. aspirin).[11,62-66]

Tokolitici – Tokolitici, kao što je ritodrin, mogu uzrokovati hipokalemiju.[67-69]

Interakcije kalija s hranjivim tvarima

Kalcij – Kalij smanjuje urinarno izlučivanje kalcija, a zajedno sudjeluju u kontrakciji mišića.[69-72]

Kofein – Kofein može zbog svog diuretičkog djelovanja uzrokovati hipokalemiju, posebno u trudnica.[69,70,73,74]

Natrij – Kalij smanjuje učinak natrijeva klorida na krvni tlak i poništava povećanje izlučivanja kalcija urinom, uzrokovano natrijem. Natrij i kalij djeluju zajedno u procesu kontrakcije mišića i provođenju živčanih impulsa.[69-72]

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