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Table 3 Pros and cons of different drugs used to treat hyperkalemia

From: Severe hyperkalemia following adrenalectomy for aldosteronoma: prediction, pathogenesis and approach to clinical management- a case series

Drugs

Pros

Cons

Fludrocortisone

1. Effective and quick resolution of hyperkalemia

2. Easy titration of dosing

3. Can be used early post operatively

1. Can cause/worsen hypertension

2. Can mask underlying renal disease

3. Can worsen edema, heart failure

Sodium bicarbonate

1. Can be used safely in CKD

2. Can be used early post operatively

1. Unfamiliarity with the drug

2. Not much data available regarding dosing regimen

Loop diuretics

1. Effective and familiar drug

2. Can be used in hypertensive population

1. Can worsen kidney disease by dehydration

Potassium binders

1. Can be used in CKD

2. Does not interfere with blood pressure

1. Can cause complications in post-operative and constipated patients