Medication-Related Electrolyte Abnormalities in Hospitalized Patients: Risk Factors and Monitoring Strategies

Abstract

Electrolyte abnormalities are common in hospitalized patients and may be associated with significant morbidity, prolonged hospitalization, and adverse clinical outcomes. Electrolyte disturbances are an important and potentially preventable cause of morbidity especially in patients on multiple drugs or with underlying co-morbidities. Many commonly prescribed drugs, such as diuretics, renin-angiotensin-aldosterone system inhibitors, proton pump inhibitors, corticosteroids, antidepressants and some antimicrobial agents, have been associated with changes in the levels of sodium, potassium, magnesium, calcium and phosphate. Other factors that might further increase the risk of medication-related electrolyte abnormalities include advanced age, renal dysfunction, cardiovascular disease, gastrointestinal losses, polypharmacy, and concomitant use of multiple medications that affect electrolyte levels. Thus, early recognition of susceptible patients and proper laboratory monitoring are important to prevent serious complications. This review summarizes major medication-related electrolyte abnormalities seen in hospitalized patients, their mechanisms and risk factors, and current approaches to electrolyte monitoring. It also discusses prevention and management strategies, and the role of clinical pharmacists in medication review, identification of high-risk patients, and optimization of electrolyte monitoring. Increased awareness and risk-based monitoring may help detect and manage medication-related electrolyte disturbances early and contribute to safer pharmacotherapy in hospitalized patients.