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- W4245942955 abstract "<h3>To the Editor.—</h3> In his Letter,<sup>1</sup>Dr Hoyt speculates that therapy with the calcium antagonist diltiazem may have exacerbated hyperkalemia in a 70-year-old patient treated with metoprolol who was consuming massive quantities of potassium as salt substitute. We wish to suggest that there is insufficient evidence to postulate a role for diltiazem therapy in such a clinical setting. Metoprolol treatment is likely to have contributed to the patient's hyperkalemia. Although the author argues against this possibility on the basis of metoprolol's β1-specificity, loss of such specificity has been well described<sup>2</sup>at daily doses of 100 mg or more (the patient was receiving 200 mg/d). Administration of 100-mg doses of metoprolol has been shown to parallel propranolol's tendency to augment the exercise-induced rise in serum potassium level,<sup>3</sup>while administration of 200mg daily doses of metoprolol may cause a significant rise in the resting serum potassium level.<sup>4</sup> Advanced" @default.
- W4245942955 created "2022-05-12" @default.
- W4245942955 date "1987-10-09" @default.
- W4245942955 modified "2023-10-18" @default.
- W4245942955 doi "https://doi.org/10.1001/jama.258.14.1891" @default.
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