It was the clen bro. Let me guess, it was underground lab, probably super over dosed. It drives the potassium straight into the cell and drops your serum potassium.
Infact when patients are admitted for hyperkalemia one of the treatmens is to give them albuterol (same family as clenbuterol) treatment. It brings down the potassium temporarily.
Not to mention all the steroids have aldosterone like effect and make you pee out potassium and hold on too sodium.
In reality it was probably a combination of all the stuff he was on but looking at his list I would think the biggest contributor was clen.
Yep, that is true, but albuterol is only a small piece of the hyperkalemic protocol. The first thing that you want to do is give calcium chloride, calcium glucanate, or kayexalate. Followed by an IV insulin drip and D50 and/or D5W (glucose). If they're really acidodic which they most likely are then they're given a bolus of sodium bicarb followed by a bicarb drip. You seem like you know what you're talking about so I'm sure I'm just telling you something that you already know, but I figured that I'd explain it just incase.
I'm sure the clen had a role in bringing the K+ down so dangerously low, but I highly doubt that it was the main culprit. I think the diuretic was the main cause for bringing him down so low which is why physicians typically prescribe Klor-Con with diuretics to prevent hypoK+.
Your buddy is VERY lucky to be alive bc the normal range for K+ is 3.7 to 5.2 mEq/L and to be honest I've never seen someone with a K+ that low and live to tell about it. Potassium is one of those electrolytes that are very sensitive and it could be lethal if its just slightly high or slightly low. Usually when the K+ is <3.0 mEq/L then cardiac arrest will soon follow. You also have to be very very careful not to bring it up or down too fast or else you can kill someone.
I can't tell you how many cardiac arrests I've ran at dialysis clinics bc their K+ gets so jacked up while they're being dialyzed and they code. The reason that its so touchy is bc it's the most prevalent intracellular cation in the human body.
Sorry to carry on, but I love medicine and the inner-geek comes out when medical topics come up.
I hope your friend pulls through and recovers fully eventually.