ABSTRACT
A common Accident and Emergency (A & E) 'salvage' operation is the rescue from certain death of patients whose plasma electrolyte balance has been dangerously disrupted by prescribed drugs every ion may be deficient or excessive in concentration, and the plasma pH and water balance may be upset. Sadly, the 'salvage' operation sometimes fails, and the patient dies due to failure of the prescriber to understand the following relatively simple facts: Remember that the adrenal hormone, aldosterone, causes sodium ion and water retention and potassium and hydrogen ion excretion by the kidneys. An actual clinical case submitted by a family doctor colleague. Consider the items in separately: These deplete all of the main plasma cations primarily K, but also Na, Ca and Mg. The elderly and patients in chronic renal failure are most at risk, but hypokalaemia, hyponatraemia, hypocalcaemia and hypomagnesaemia can occur at any age and without renal impairment in patients who are taking loop diuretics.
