Possible Interaction: Adrenergic Beta-Antagonists and Potassium

“ Beta-blockade caused further increase in potassium at any given workload.”

“Plasma potassium concentrations during exercise were significantly increased with all three beta-blockers.”

“ Potassium concentrations were consistently 0-2-0-3 mmol (mEq)/l higher during beta-blockade than with placebo (p<0-001 by paired t test), regardless of selectivity, and fell significantly during the three hours after glucose administration (p <0 001) on all treatments, including placebo.”

“Sodium intake is associated with proteinuria and … renin‐angiotensin‐aldosterone system (RAAS) blockers which are commonly used to reduce proteinuria and improve renal outcome.3 Oral potassium loading can suppress renin … and decrease blood pressure.4,5 These mechanisms may be important in the anti‐ proteinuric effect of potassium.”

“Antiarrhythmic drugs class IA (quinidine, disopyramide), class III (sotalol, amiodarone), … (calcium channel blockers) used at the same time with potassium depleters diuretics … beta-blocking agents result in the inhibition of repolarization and the increased duration of activation … with the risk of developing arrhythmia of the torsade de pointes types.”

“For several years now, it has been known that the administering of adrenergic beta antagonists , especially of the beta-2 type, induce hypokalemia as a result of the entering of potassium into the skeletal muscle cells.”

“Recent experimental and clinical reports have demonstrated that beta-adrenergic blockade impairs and beta-adrenergic stimulation enhances in vivo extrarenal potassium uptake in man.”

“The fact that beta-blockade inhibits 86Rb (K) influx and increases plasma potassium concentration implies that endogenous adrenaline exerts a tonic stimulatory effect upon 86Rb (K) influx and a suppressive effect on plasma potassium concentrations in vivo.”

“In summary, alpha-adrenergic blockade ameliorates exercise-induced hyperkalemia in diabetic but not in control subjects, nonspecific beta-adrenergic blockade causes a greater increment in potassium when compared with exercise alone, and specific beta 1-adrenergic blockade exacerbates exercise-induced hyperkalemia in control, but not in diabetic subjects.”

“Sodium and potassium values increase in the samples with the beta-blocking agent and are statistically significant only after 20'; in further controls the increasing values persist.”