<prompt> The causes of hypokalemia include the following except-Tamoxifen therapyACTH producing tumorsNon-bilious vomitingDiabetic ketoacidosis  <response>: I. Decreased intake A. Starvation B. Clay ingestion II. Redistribution into cells A. Acid-base 1. Metabolic alkalosis B. Hormonal 1. Insulin 2. Increased b2-adrenergic sympathetic activity: post-myocardial infarction, head injury 3. b2-Adrenergic agonists - bronchodilators, tocolytics 4. a-Adrenergic antagonists 5. Thyrotoxic periodic paralysis 6. Downstream stimulation of NaK-ATPase: theophylline, caffeine C. Anabolic state 1. Vitamin B12 or folic acid administration red blood cell production 2. Granulocyte-macrophage colony-stimulating factor white blood cell production 3. Total parenteral nutrition D. Other 1. Pseudohypokalemia 2. Hypothermia 3. Familial hypokalemic periodic paralysis 4. Barium toxicity: systemic inhibition of leak K channels III. Increased loss A. Nonrenal 1. Gastrointestinal loss diarrhea 2. Integumentary loss sweat B. Renal 1. Increased distal flow and distal Na delivery: diuretics, osmotic diuresis, salt-wasting nephropathies 2. Increased secretion of potassium a. Mineralocoicoid excess: primary hyperaldosteronism aldosterone- producing adenomas, primary or unilateral adrenalhyperplasia, idiopathic hyperaldosteronism due to bilateral adrenal hyperplasia, and adrenal carcinoma, genetic hyperaldosteronism familial hyperaldosteronism types IIIIII, congenital adrenal hyperplasias, secondary hyperaldosteronism malignant hypeension, renin-secreting tumors, renal aery stenosis, hypovolemia, Cushings syndrome, Baters syndrome, Gitelmans syndrome b. Apparent mineralocoicoid excess: genetic deficiency of 11b-dehydrogenase-2 syndrome of apparent mineralocoicoid excess, inhibition of 11b-dehydrogenase-2 glycyrrhetinic glycyrrhizinic acid andor carbenoxolone; licorice, food products, drugs, Liddles syndrome genetic activation of epithelial Na channels c. Distal delivery of nonreabsorbed anions: vomiting, nasogastric suction, proximal renal tubular acidosis, diabetic ketoacidosis, glue-sniffing toluene abuse, penicillin derivatives penicillin, nafcillin, dicloxacillin, ticarcillin, oxacillin, and carbenicillin 3. Magnesium deficiency ref: harrisons ,19 E , PG -305 