Question

Raltegravir can cause which of the following?

• A. Hypokalemia
• B. Hypocalcemia
• C. Hyperkalemia
• D. Hypercalcemia

Hint:

Trace the effect through raltegravir induced rhabdomyolysis.

Answer 1

The Correct Option is C

Step 1: Raltegravir is an HIV integrase strand transfer inhibitor. Its documented adverse effects include myopathy and rhabdomyolysis, skin and allergic reactions, liver problems, immune reconstitution inflammatory syndrome, and nonspecific symptoms such as nausea, vomiting, diarrhoea, and headache.

Step 2: No standard text lists a direct electrolyte disturbance for raltegravir, so the link is made through one of its recognised toxicities, namely rhabdomyolysis.

Step 3: In rhabdomyolysis, damaged muscle cells release their intracellular contents, including large amounts of potassium, into the blood. This produces hyperkalemia, which is the electrolyte abnormality that fits.

Step 4: The other options do not follow from muscle breakdown. Rhabdomyolysis releases potassium (raising it, not lowering it) and tends to cause hypocalcemia only as a secondary phenomenon, while calcium elevation is not expected. The best supported choice is hyperkalemia.