SHM Converge Scientific Abstract ePoster Gallery-Losartan-Induced Electrolyte Depletion

Pdf Summary

A 59-year-old man with newly diagnosed hypertension and prediabetes presented after an unwitnessed syncopal episode while standing. Two days earlier, he had started losartan 25 mg daily and since then reported dizziness, lightheadedness, and urinary frequency. He also had been drinking one cup of burdock root tea daily for several weeks, containing burdock root, dandelion root, red clover, yellow dock, senna leaf, licorice root, and ginger root.<br /><br />On presentation, he was bradycardic but otherwise had normal vital signs and an unremarkable exam. Initial evaluation showed normal CBC, negative troponin, sinus bradycardia on EKG, and normal chest x-ray and head CT. Labs revealed marked electrolyte abnormalities: hypokalemia, hypocalcemia, hypomagnesemia, and hypophosphatemia, with low bicarbonate and improved creatinine.<br /><br />The case highlights that while losartan is most commonly associated with hyperkalemia, it can also increase urinary excretion of sodium, potassium, chloride, magnesium, uric acid, calcium, and phosphorous, potentially causing clinically significant electrolyte depletion. The patient’s herbal supplement may have contributed as well, since burdock root preparations can have diuretic effects and some ingredients may affect potassium balance or drug metabolism.<br /><br />He was treated with IV calcium gluconate, magnesium sulfate, potassium replacement, and IV fluids. Losartan was discontinued and he was advised to stop the burdock root supplement. His electrolytes and symptoms normalized by the next hospital day.<br /><br />Take-home point: after starting losartan, clinicians should monitor not only for hyperkalemia and renal dysfunction, but also for less common electrolyte depletion, especially when patients use herbal supplements or other agents with diuretic or electrolyte-altering effects.

Asset Subtitle

Aisha Uraizee

Meta Tag

Author List Aisha Uraizee, Shaheena Khan, Shawna Gloe

Category Clinical Vignettes

Concept Losartan

Concept Angiotensin Receptor Blocker

Concept Electrolyte Depletion

Concept Syncope

Concept Angiotensin II Receptor

Distinguished Non-Finalist

Presenter Organization Medical College of Wisconsin

Presenting Author Aisha Uraizee

Track Adult

Keywords

losartan

syncope

electrolyte depletion

hypokalemia

hypocalcemia

hypomagnesemia

hypophosphatemia

burdock root tea

herbal supplement

diuretic effect

Losartan

Angiotensin Receptor Blocker

Electrolyte Depletion

Syncope

Angiotensin II Receptor