Compartmental Shift of Potassium—A Result of Sympathomimetic Overdose

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Abstract
A 17 yr old youth was admitted with a serum K concentration of 1.8 mmol/l after taking an overdose of pseudoephedrine and choline theophyllinate. Apart from tachycardia, tachypnea and ankle clonus, examination was normal as was the initial electrocardiograph. The hypokalemia resolved, but there was an overall positive K balance of only 13 mmol. Apparently sympathomimetics provoked a compartmental shift of K perhaps indirectly by inducing hyperglycemia and hyperinsulinemia, as well as directly. Other factors known to affect body K distribution were excluded. Features commonly associated with hypokalemia could not be demonstrated, and this may be explained by a normal body K content. Severe hypokalemia caused by a compartmental shift occurs with large doses of sympathomimetics and in periodic paralysis.

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