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International Journal of Clinical Pharmacy

, Volume 36, Issue 6, pp 1130–1133 | Cite as

A case of probable labetalol induced hyperkalaemia in pre-eclampsia

  • Binny ThomasEmail author
  • P. V. Abdul Rouf
  • Wessam El Kassem
  • Moza Al Hail
  • Derek Stewart
  • Asma Tharannum
  • Afif Ahmed
  • Muna Al Saadi
Case Report

Abstract

Case description Hyperkalemia can cause altered cardiac electrical conduction resulting in death. We describe a case of a 23-year old pregnant patient who presented with severe epigastric pain and vomiting. She was severely pre- eclamptic and received initial treatment with intravenous labetalol and decision was taken to deliver. She quickly became hyperkalaemic (serum potassium level 6.4 mmol/L) and labetalol was discontinued and intravenous hydralazine commenced. Post-surgery, her potassium levels were normal but due to rapidly rising blood pressure labetalol was recommenced, resulting in elevated potassium levels. Labetolol was discontinued, hydralazine prescribed, and potassium levels normalised. The adverse reaction was classified as ‘probably’ due to labetolol using the Naranjo Adverse Drug Reaction scale. Conclusion This is the first reported case of labetolol induced hyperkalaemia in pregnancy, with life threatening consequences and hence all health professionals should be alert to this potential effect.

Keywords

Hyperkalemia Labetolol Pre-eclampsia Pregnancy 

Notes

Acknowledgments

Authors would like to acknowledge Dr. Katie MacLure, Dr. Doua Al Saad and Dr. Mahmoud Gasim.

Funding

None.

Conflicts of interest

None.

References

  1. 1.
    Arulkumaran N, Lightstone L. Severe pre-eclampsia and hypertensive crises. Best Pract Res Clin Obstet Gynaecol. 2013;27:877–84.PubMedCrossRefGoogle Scholar
  2. 2.
    Vigil-De Gracia P, Lasso M, Ruiz E, Vega-Malek JC, de Mena FT, López JC. Severe hypertension in pregnancy: Hydralazine or labetalol—A randomized clinical trial. Eur J Obstet Gynaecol RB 2006;128:157–162.Google Scholar
  3. 3.
    Evans K, Greenberg A. Hyperkalaemia: A review. J Int Care Med. 2005;20:272–90.CrossRefGoogle Scholar
  4. 4.
    McCauley J, Murray J, Jordan M, Scantlebury V, Vivas C, Shapiro R. Labetalol-induced hyperkalaemia in renal transplant recipients. Am J Nephrol. 2002;22:347–51.PubMedCrossRefGoogle Scholar
  5. 5.
    Hawboldt J, McGrath D. Possible Metoprolol-Induced Hyperkalaemia. J Pharm Pract. 2006;19:320–5.CrossRefGoogle Scholar
  6. 6.
    Medicines and Healthcare products Regulator Agency (MHRA). http://www.mhra.gov.uk. (Accessed April 14, 2014).
  7. 7.
    Canadian Adverse Drug Reaction Monitoring Program Database. http://www.hc-sc.gc.ca/dhp-mps/medeff/databasdon/index-eng.php (Accessed April 14, 2014).
  8. 8.
    Zaki SA. Adverse drug reaction and causality assessment scales. Lung India. 2011;28:152–3.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Morton A. Severe hyperkalaemia peripartum with magnesium sulphate. Obstet Med. 2012;5:86–7.CrossRefGoogle Scholar
  10. 10.
    Labetalol. In: Aronson JK, editor. Meyler’s side effects of drugs: The International Encyclopaedia of Adverse Drug Reactions and Interactions (Fifteenth Edition) Amsterdam: Elsevier; 2006. p. 1985–1986.Google Scholar

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2014

Authors and Affiliations

  • Binny Thomas
    • 1
    Email author
  • P. V. Abdul Rouf
    • 1
  • Wessam El Kassem
    • 1
  • Moza Al Hail
    • 1
  • Derek Stewart
    • 1
  • Asma Tharannum
    • 1
  • Afif Ahmed
    • 1
  • Muna Al Saadi
    • 1
  1. 1.Hamad Medical CorporationDohaQatar

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