American Board of Medicolegal Death Investigators (ABMDI) Practice Exam

What drug is commonly associated with causing electrolyte imbalance?

1. Ibuprofen

2. Salicylate (aspirin)

3. Prednisone

4. Metformin

The correct answer is: Salicylate (aspirin)

The correct choice is salicylate (aspirin) because it can indeed cause electrolyte imbalances, primarily due to its effect on the kidneys and its potential to lead to metabolic changes. In cases of salicylate toxicity or overdose, it can result in a metabolic acidosis, which alters the balance of electrolytes such as bicarbonate, sodium, and potassium. It can increase the excretion of potassium, leading to low levels (hypokalemia), along with other electrolyte disturbances. Understanding how salicylates can disrupt normal electrolyte levels is crucial for medical professionals, particularly in acute care settings where prompt identification and management of such imbalances can significantly impact patient outcomes. Other drugs mentioned have distinct mechanisms of action and are associated with different physiological effects, making them less likely to directly cause significant electrolyte imbalances in the same manner. For instance, ibuprofen is primarily a non-steroidal anti-inflammatory drug (NSAID) that may affect renal function but is less frequently associated with direct electrolyte disturbances compared to salicylates. Prednisone, as a corticosteroid, can influence electrolyte balance (especially causing sodium retention and potassium loss) but does not have the same acute risks associated with salicylate toxicity. Metformin primarily affects glucose