• DOI:10.1177/106002809102500426
• Corpus ID: 38483686

Comment: Potassium Supplements vs. Potassium-Sparing Diuretics

@article{OKeeffe1991CommentPS,
  title={Comment: Potassium Supplements vs. Potassium-Sparing Diuretics},
  author={Shaun T. O’Keeffe},
  journal={Annals of Pharmacotherapy},
  year={1991},
  volume={25},
  pages={439 - 439}
}

• S. O’Keeffe
• Published 1 April 1991
• Medicine
• Annals of Pharmacotherapy

TO THE EDITOR: I wish to comment on the question of potassium supplements versus potassium-sparing diuretics in treating thiazideinduced hypokalemia (DICP 1990;24:710-1). Magnesium deficiency is also a common adverse effect of prolonged thiazide therapy. I In patients with congestive heart failure (CHF), hyperaldosteronism and digitalis therapy also promote urinary excretion of magnesium. Low serum magnesium is associated with increased arrythmias and mortality in CHF.Z Frequently magnesium deficiency goes undetected because serum determinations do not adequately reflect the total body content of this mainly intracellular cation." Magnesium is an essential cofactor for the cellular pumps that maintain cellular potassium. A diureticinduced cellular potassium depletion cannot be corrected by potassium supplements alone when a magnesium deficiency is present. Cellular depletion of magnesium and potassium is associated with an increased risk of cardiac arrythmias and increases the risk of digitalis toxicity. In one study of patients who were initially hypokalemic, ventricular ectopic beats were reduced by potassium infusion only after magnesium had been replaced.' Both magnesium and potassium repletion are necessary for patients with documented hypokalemia. Potassium-sparing diuretics have a magnesium-sparing effect, and can maintain intraand extracellular balance of both electrolytes.' In my view, they are a more suitable