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: Begin from the toxicity profile of raltegravir, the integrase inhibitor used in HIV therapy. A well known but serious effect is muscle injury that can progress to rhabdomyolysis.

Step 2: Rhabdomyolysis means skeletal muscle cells are breaking apart. Potassium is the dominant cation stored inside cells, so when muscle membranes rupture, potassium floods into the circulation.

Step 3: The net laboratory result of this potassium leak is a high serum potassium level, that is hyperkalemia, which can be dangerous for cardiac rhythm.

Step 4: The remaining options point the wrong way. A drop in potassium or a rise in calcium would not arise from muscle destruction, and any calcium change in rhabdomyolysis is typically a fall, not a rise. So the answer derived through the rhabdomyolysis pathway is hyperkalemia.

\[\boxed{\text{Hyperkalemia}}\]