{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T22:58:23Z","timestamp":1777417103984,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2000,5,1]],"date-time":"2000-05-01T00:00:00Z","timestamp":957139200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2000,5]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To report the use of fludrocortisone for heparin-induced hyperkalemia and to briefly review the available literature relating to heparin-induced hyperkalemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CASE SUMMARY:<\/jats:title>\n                    <jats:p>A 34-year-old African-American man was admitted to the hospital for pneumococcal pneumonia and sepsis. His hospital course was complicated by the development of acute respiratory distress syndrome, severe sepsis, acute renal failure, placement of a tracheostomy, and recurrent nasopharyngeal bleeding. The patient also developed a subclavian vein thrombosis with extension to the cephalic and basilic veins secondary to placement of a pulmonary artery catheter; anticoagulation with heparin was required. On day 9 of heparin therapy, the patient developed symptomatic hyperkalemia refractory to conventional therapies. Oral fludrocortisone 0.1 mg\/d was initiated with resolution of the hyperkalemia within 24 hours despite the continued administration of heparin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA SOURCES:<\/jats:title>\n                    <jats:p>A MEDLINE (1966\u2013October 1999) search was performed to identify case reports and clinical trials discussing heparin-induced hyperkalemia or the use of fludrocortisone for hyperkalemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>Heparin has the potential to induce hyperkalemia by several mechanisms, including decreased aldosterone synthesis, reduction in number and affinity of aldosterone II receptors, and atrophy of the renal zona glomerulosa. Fludrocortisone promotes potassium excretion by its direct actions on the renal distal tubules. In this patient, fludrocortisone resulted in a significant and rapid decrease in serum potassium even with continued heparin administration and acute renal failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>This case suggests that fludrocortisone is a reasonable alternative therapy for patients with hyperkalemia secondary to heparin therapy when the continued administration of heparin is necessary.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.19326","type":"journal-article","created":{"date-parts":[[2003,6,3]],"date-time":"2003-06-03T16:38:03Z","timestamp":1054658283000},"page":"606-610","source":"Crossref","is-referenced-by-count":23,"title":["Fludrocortisone for the Treatment of Heparin-Induced Hyperkalemia"],"prefix":"10.1177","volume":"34","author":[{"given":"Deb S","family":"Sherman","sequence":"first","affiliation":[{"name":"Deb S Sherman PharmD, Critical Care Specialty Resident, Department of Pharmacy Practice, School of Pharmacy, University of Colorado Health Sciences Center, Denver, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carrie L","family":"Kass","sequence":"additional","affiliation":[{"name":"Carrie L Kass PharmD, at time of writing, PharmD Student, School of Pharmacy, University of Colorado Health Sciences Center; now, Virology Project Leader, Drug Safety Surveillance Department, Agouron Pharmaceuticals, La Jolla, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas N","family":"Fish","sequence":"additional","affiliation":[{"name":"Douglas N Fish PharmD BCPS, Associate Professor of Pharmacy, Department of Pharmacy Practice, School of Pharmacy, University of Colorado Health Sciences Center; Clinical Specialist in Critical Care, Department of Pharmacy, University Hospital, Denver, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2000,5,1]]},"reference":[{"key":"bibr1-aph.19326","first-page":"221","volume":"31","author":"Tolstoi LG","year":"1996","journal-title":"Hosp Pharm"},{"key":"bibr2-aph.19326","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(99)80017-5"},{"key":"bibr3-aph.19326","doi-asserted-by":"publisher","DOI":"10.1177\/106002809002400305"},{"issue":"25","key":"bibr4-aph.19326","first-page":"S196","volume":"34","author":"Durand D","year":"1988","journal-title":"Kidney Int"},{"key":"bibr5-aph.19326","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1985.00360060134021"},{"key":"bibr6-aph.19326","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.1990.11704598"},{"key":"bibr7-aph.19326","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1981.03320190047027"},{"key":"bibr8-aph.19326","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(64)90110-X"},{"key":"bibr9-aph.19326","volume-title":"Heparin sodium","year":"1997"},{"key":"bibr10-aph.19326","first-page":"446","volume":"29","author":"Gonzalez-Martin G","year":"1991","journal-title":"Int J Clin Pharmacol Ther Toxicol"},{"key":"bibr11-aph.19326","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-26-5-527"},{"key":"bibr12-aph.19326","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-56-1-108"},{"key":"bibr13-aph.19326","doi-asserted-by":"publisher","DOI":"10.1016\/0049-3848(92)90301-P"},{"key":"bibr14-aph.19326","doi-asserted-by":"publisher","DOI":"10.1007\/BF01745482"},{"key":"bibr15-aph.19326","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"},{"key":"bibr16-aph.19326","doi-asserted-by":"publisher","DOI":"10.1159\/000168604"},{"key":"bibr17-aph.19326","volume-title":"Florinef (fludrocortisone acetate)","year":"1996"},{"key":"bibr18-aph.19326","doi-asserted-by":"publisher","DOI":"10.1007\/BF00558513"},{"key":"bibr19-aph.19326","first-page":"46","volume":"18","author":"Greenberg A","year":"1998","journal-title":"Semin Nephrol"},{"key":"bibr20-aph.19326","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1594.1998.06204.x"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.19326","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.19326","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:03:25Z","timestamp":1777374205000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.19326"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,5]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2000,5]]}},"alternative-id":["10.1345\/aph.19326"],"URL":"https:\/\/doi.org\/10.1345\/aph.19326","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,5]]}}}