[LABORATORY TEST] Blood Chemistry - Electrolytes

Proverbs 16:3

Hyponatremia

[SODIUM]

Low concentration of Na in the blood

• Na loss → result of aldosterone deficiency and renal disease

• Excessive water retention → diluted blood caused by CHF and cirrhosis

• May also be caused by Inappropriate secretion of ADH

• Use of Antidepressants, Amphotericin, ACEIs, Carbamazepine, Cisplatin, Cyclophosphamide, Gliclazide, Levothyroxine, NSAIDs, PPIs, Tolbutamide, Vasopressin, and Vincristine.

Causes that lead to HYPOnatremia [4]

• Antidepressants

• Amphotericin B

• ACEIs

• Carbamazepine

• Cisplatin

• Cyclophosphamide

• Gliclazide

• Levothyroxine

• NSAIDS

• PPIs

• Tolbutamide

• Vasopressin

• Vincristine

📌Mnemonic: A³ C³ “GLNP” “TVV”

Drugs that causes HYPOnatremia [13]

• Hyponatremia

• Hypomagnesemia

[DRUGS THAT CAUSE MULTIPLE CONDITIONS]

Amphotericin B

a. Hypokalemia

b. Hyponatremia

c. Hypomagnesemia

d. b and c

• Hyponatremia

• Hypomagnesemia

[DRUGS THAT CAUSE MULTIPLE CONDITIONS]

Cisplatin

a. Hypokalemia

b. Hyponatremia

c. Hypomagnesemia

d. b and c

• Hypokalemia

• Hypercalcemia

• Hypomagnesemia

[DRUGS THAT CAUSE MULTIPLE CONDITIONS]

Loop diuretics (Furosemide)

a. Hypokalemia

b. Hypercalcemia

c. Hypomagnesemia

d. b and c

e. a,b,c

• Hypokalemia

• Hypercalcemia

• Hypomagnesemia

[DRUGS THAT CAUSE MULTIPLE CONDITIONS]

Thiazide diuretics (HCTZ)

a. Hypokalemia

b. Hypercalcemia

c. Hypomagnesemia

d. b and c

e. a,b,c

• Hypokalemia (GIT Loss)

• Hypomagnesemia

[DRUGS THAT CAUSE MULTIPLE CONDITIONS]

Laxatives

a. Hypokalemia

b. Hyponatremia

c. Hypomagnesemia

d. a and c

Hypernatremia

[SODIUM]

_______-

• High concentration of sodium

• Occurs when there is too much water loss or too much sodium gain in the body

Sodium

[Electrolytes]

Most common in the extracellular fluid

Hypokalemia

[Potassium]

Low concentration of K in the blood

a. Hypokalemia

b. Hyponatremia

c. Hypomagnesemia

d. b and c

• Shift of K ions from ECF into the cells (B2 agonists, parenteral insulin, catecholamines)

• Loss from GIT (laxative abuse, diarrhea, persistent vomiting)

• Loss from the kidneys (hyperaldosteronism (Cushing’s syndrome), renal tubular damage, thiazide and loop diuretics)

[Potassium]

Causes that lead to HYPOkalemia [3]

• B2 agonists

• Parenteral insulin

• Catecholamines

• Loop diuretics

• Thiazide diuretics

Drugs that causes HYPOkalemia [5]

Hyperkalemia

[Potassium]

High concentration of Potassium in the blood

• Excessive intake of K

• Renal Failure

Causes that lead to HYPERkalemia [2]

K sparring diuretics

Drug that cause HYPERkalemia [1]

Magnesium

[Electrolytes]

Important in muscles and soft tissue structure

Hypomagnesemia

[Magnesium]

Low concentration of Mg in the blood due to GI and renal losses, trauma, infection, malnutrition, sepsis

• GI and renal losses

• Trauma

• Infection

• Malnutrition

• Sepsis

[Magnesium]

Causes that lead to HYPOmagnesemia [5]

Hypermagnesemia

[Magnesium]

______-

• High concentration of magnesium in blood

• Caused by renal insufficiency

Renal insufficiency

[Magnesium]

Causes that lead to HYPERmagnesemia [1]

• Cisplatin

• Amphotericin B

• Ciclosporin

• Aminoglycosides

• Laxatives

• Pentamidine

• Tacrolimus

• Carboplatin

• Furosemide

• HCTZ

• Digoxin

'📌Mnemonic: “CACA” LPT “CFHD”

Drugs that causes HYPOmagnesemia [11]

Calcium

[Electrolytes]

Most important component of bones wherein 40% of it is bound in albumin

Parathyroid/Vitamin C Deficiency

[Calcium]

Causes that lead to HYPOcalcemia [1]

• Loop diuretics

• Thiazide diuretics

Drugs that causes HYPERcalcemia [2]

• Malignancy

• Hyperparathyroidism (Osteoporosis)

• Paget’s Disease – bone breakdown

• Diuretics (Loop, Thiazide)

• Vit. D intoxications

📌Mnemonic: “MHP” DV

[Calcium]

Causes that lead to HYPERcalcemia [4]

Osteomalacia

Caused by hypoparathyroidism wherein there is a low phosphate level that can cause bone softness making them weak and brittle

Paget's Disease

It increases bone breakdown that causes reorganization of bones.

• Aluminum antacids

• Renal losses

• Hyperparathyroidism

[Electrolytes]

Causes that lead to HYPOphosphatemia[3]

Aluminum antacids

Drug that causes HYPOphosphatemia [1]

• Renal dysfunction

• Vitamin D toxicity

• Hypothyroidism

[Phosphate]

Causes that lead to HYPERcalcemia [3]

Calcium and Phosphate

[Bone and Mineral Homeostasis]

These two are the major constituents of bone

• Parathyroid Hormone (PTH)

• Vitamin D

Principal Regulatory Hormones include ______ [2]

Parathyroid Hormone (PTH)

[Principal Regulatory Hormones]

This hormone increases bone resorption (high Ca = low phosphate)

TRUE

[Principal Regulatory Hormones]

TRUE OR FALSE

In Parathyroid Hormone (PTH)

• Increase bone resorption → increase calcium → decrease phosphate

Vitamin D

[Principal Regulatory Hormones]

_______-

• Produced from the skin

• Stimulates intestinal Ca and PO4 transport and absorption

• This increases both calcium and phosphate

Calcium and Phosphate

Vitamin D increases both _____ and ______

D3 (cholecalciferol)

Most common Vitamin D that came from animal source

D2 (ergocalciferol)

It is a vitamin D that is a plant source

• Estrogen

• Calcitonin

• Glucocorticoids

Secondary Regulatory Hormones include [3]

Calcitonin

[Secondary Regulatory Hormones]

This inhibits resorption (low calcium and low phosphate)

Glucocorticoids

[Secondary Regulatory Hormones]

_______-

• This antagonizes Vitamin D

• This stimulates renal excretion of Calcium

Estrogen

[Secondary Regulatory Hormones]

Reduce bones resorption of PTH