QUESTION: My patient who went into A-FIB (actually following a cold where he took sudafed several days in a row!!)… anyways… the ER labs are showing that his serum potassium was 3.8 in the ER. The low end of normal is 3.5. So my question is, in patients with a-fib, do you want their serum potassium to be closer to 5? He is hetero for Ace Del 16. So perhaps if he was on a potassium supplement, it could have been prevented? He wants off his Diltiazem and Losartan — but while he’s on the Losartan — I can’t give him potassium supplements. But perhaps when he stops taking these drugs? (his cardiologist is OK with him getting off them if he stabilizes).
ANSWER: You “can” give K while on ANG drugs if you check serum K weekly. That said, yes all things considered I like it higher in the normal range, as well as a higher RBC Mag, and supplement with Taurine 1-2 grams BID
