Hyperkalemia from B-blockers B2 antagonism, not b1

[aspiringmd1015]

B agonists induce the na/k atpase pump, and blocking that can cause hyperkalemia. But this effect is B2 initiated, as previously i thought the b1 blocking effect of decreasing renin would cause hyperkalemia but according to UW its the b2 effect. QID 697. Can anyone shed some light on this

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[Kazaki]

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[Kazaki]

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[Old Timer]

Two possible MOA:

1. Beta blockers suppress catecholamine-stimulated renin release, thereby decreasing aldosterone synthesis.
2. More importantly nonselective beta blockers decrease cellular uptake of potassium.

It's more common with non-selective Beta blockers and I also think it's more common in patients with renal failure. I would think it's most likely due to #2 as decreased renin due to beta blocker therapy would take time and many patients in the hospital have a sudden increases in K levels soon after initiation of beta blocker therapy.