Question

An elderly man, who is a known case of diabetic nephropathy, presented to the emergency with palpitations and chest discomfort. ECG showed tall T-waves. Laboratory investigations showed elevated potassium levels. Which of the following drugs will cause the shift of potassium back into the cell?

• A. Epinephrine
• B. Glucagon
• C. Atropine
• D. Lactic acid

Answer 1

The Correct Option is A

In the given scenario, the patient presents with hyperkalemia, evidenced by elevated potassium levels and ECG changes such as tall T-waves. To address hyperkalemia, it is crucial to shift the excess potassium from the extracellular space back into the cells.

Epinephrine is a drug that can achieve this effect. It works via stimulating beta-2 adrenergic receptors, leading to activation of the sodium-potassium ATPase pump which facilitates the intracellular uptake of potassium. Therefore, the administration of epinephrine is effective in the acute management of hyperkalemia by promoting potassium shift into cells.

Other options provided do not have the same effect:

Drug	Mechanism
Glucagon	Primarily used to treat hypoglycemia, insufficient evidence in potassium shift
Atropine	Anticholinergic with no effect on potassium shift
Lactic acid	Not used for shifting potassium into cells

Thus, the correct choice is Epinephrine due to its specific action of driving potassium into the cells by increasing the activity of the Na+/K+ ATPase.