Therapeutics - Electrolytes - K

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Author:
kyleannkelsey
ID:
260683
Filename:
Therapeutics - Electrolytes - K
Updated:
2014-02-06 23:24:17
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Therapeutics Electrolytes
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Therapeutics - Electrolytes - K
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Therapeutics - Electrolytes - K
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  1. What types of drugs can cause Hypokalemia?
    • Cellular K redistributing
    • Renal potassium wasting and Hypomagnesemia inducing
  2. What drugs can cause hypokalemia?
    • Albuterol
    • insulin (Cellular K redistributing)
    • Diuretics
    • High dose antibiotics and corticosteroids (Renal wasting)
    • Aminoglycosides
    • Amp.B
    • Cisplatin and Foscament (Mg depleters)
  3. What drugs can cause HYPERkalemia?
    • K-sparing
    • Cyclosporine
    • ACEIs
    • BB
    • TMP/SMX
    • NSAIDs
    • Pentamidine
    • Heparin/LMWH
    • Digoxin
    • Succinylcholine
    • Tacrolimus
    • Potassium supplements

    (Kelsey can always bring three Nalgene’s per hot destination so take pants)
  4. What medications/treatments are available for Hypokalemia?
    • Potassium chloride
    • gluconate
    • citrate
    • acetate and bicarbonate
  5. What are the EKG symptoms of Hypokalemia?
    Flattening of the T wave and Elevation of the U wave
  6. What are the s/s of Hypokalemia?
    • Polyuria
    • EKG (flat T-wave
    • incr. U-wave)
    • Digoxin toxicity
    • increased pH/Bicarb
    • N/V paralytic ilius
  7. For every 1 mEq/L fall in K
    • what is the corresponding drop in total body deficit?
    • ~200 mEq
  8. What type of Potassium would you use if a person has Alkalosis and HYPOkalemia?
    KCl
  9. What type of Potassium would you use if a person has Acidosis and HYPOkalemia?
    • Bicarbonate
    • gluconate
    • citrate or acetate
  10. How is moderate (2.5-3.5 mEq/L) HYPOkalemia usually treated when no EKG changes are present?
    • Oral
    • 40-120 mEq/day (or [4-K] x 100)
  11. How is severe (<2.5 mEq/L) HYPOkalemia usually treated when w/ or w/o EKG changes?
    • IV
    • avoid glucose solution
    • correct any Mg deficits
    • Max rate : 10 mEq/hr (peripheral) 40 mEq/hr (central)
    • Max conc.: 40 mEq/L (peripheral) 80 mEq/L (central)
    • cardiac monitoring over 10 mEq/hr
  12. What diseases can cause HYPERkalemia?
    • Addison’s disease
    • renal failure
    • tissue breakdown
    • metabolic acidosis
  13. What medications can be used to treat HYPERkalemia?
    • Dextrose
    • Insulin
    • sodium bicarbonate
    • Sodium polysturene sulfonate (kayexalate)
    • Loop/thiazide diuretics
    • Hemodialysis and Discontinue K sparing drugs

    (Don’t insult Sally because she likes her dress)
  14. What are the s/s of HYPERkalemia?
    • Muscle weakness
    • Paresthesias
    • GI hypertrophy
    • hypotension
    • EKG changes
    • arrhythmias
    • dec. pH
    • de. Cardiac conduction
    • V-fib
  15. What are the EKG changes associated with HYPERkalemia?
    • Widened QRS complex
    • Shortened Q-T segment and Peaked T-wave
  16. What is a normal treatment regimen for HYPERkalemia?
    • 1g CaCl infused directly or in 50mL D5W over 15 min
    • 50% dextrose IV over 5 min
    • 10% dextrose w/ 20 U regular insulin over 1-2h
    • Sodium polysturene 15-60g or 10-20 nebulizer albuterol over 10 min
  17. How can you promote ECF to ICF movement of K during HYPERkalemia?
    • Dextrose
    • insulin and sodium bicarbonate
  18. When can you use albuterol for HYPERkalemia?
    Non-acute situations
  19. When is IV calcium indicated for HYPERkalemia?
    >7 mEq/L or EKG changes
  20. When is Dextrose/sodium bicarb/insulin recommended for HYPERkalemia?
    [K] > 6.0 mEq/L or EKG changes

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