Final answer:
In patients with high serum potassium levels, antihypertensives such as ACE inhibitors and ARBs should be used with caution since they can increase serum potassium. Instead, beta blockers and calcium channel blockers are safer choices as they do not typically raise potassium levels. Therefore, the correct option is C, D.
Step-by-step explanation:
If a patient has elevated serum potassium (hyperkalemia), care must be taken when prescribing antihypertensive medications that can potentially increase potassium levels further. Known classes of antihypertensives that can raise serum potassium are angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs). These drugs inhibit the renin-angiotensin-aldosterone system, which can lead to decreased potassium excretion and increased serum potassium levels.
While both ACE inhibitors, such as lisinopril, and ARBs, including losartan and valsartan, are effective for treating hypertension, they should be used with caution in patients who have high serum potassium levels. Monitoring of potassium levels is essential when these medications are used. In contrast, beta blockers such as metoprolol and propranolol, and calcium channel blockers like amlodipine, do not typically increase serum potassium and therefore would be safer choices in patients with hyperkalemia.