Sulfonamides · Pharmacology

A patient taking Sulfamethoxazole-Trimethoprim develops a significant rise in serum potassium. This is most likely due to the effect of which component?

  1. Sulfamethoxazole causing renal tubular acidosis
  2. Trimethoprim blocking the distal tubule sodium channel
  3. Sulfamethoxazole suppressing adrenal aldosterone synthesis
  4. The combination causing massive bacterial lysis
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Correct answer: Trimethoprim blocking the distal tubule sodium channel

Trimethoprim is structurally related to the potassium-sparing diuretic amiloride and blocks the epithelial sodium channel (ENaC) in the distal nephron. Reduced sodium reabsorption there lowers potassium excretion, so serum potassium rises.

Difficulty: Medium Question 19 of 20

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