Bear RA, Wingo CS. Hyperkalaemia in patients in hospital. Shemer J, In response to acidosis, extracellular hydrogen is exchanged for intracellular potassium, although the net result is highly variable and depends in part on the type of acidosis; metabolic acidosis produces the greatest effect.Medication use is a common cause of hyperkalemia, particularly in patients with baseline renal dysfunction or hypoaldosteronism.ACE inhibitors contributed to one-half of all cases of drug-induced hyperkalemia in one sample, and approximately 10% of outpatients who start an ACE inhibitor or an ARB will develop hyperkalemia within one year.As with hypokalemia, the immediate danger of hyperkalemia is its effect on cardiac conduction and muscle strength, and initial efforts should focus on determining the need for urgent intervention Suggested algorithm for the evaluation of hyperkalemia.Suggested algorithm for the evaluation of hyperkalemia.Severe hyperkalemia (more than 6.5 mEq per L [6.5 mmol per L]) can cause muscle weakness, ascending paralysis, heart palpitations, and paresthesias. Gastrointestinal adverse events with sodium polystyrene sulfonate (Kayexalate) use: a systematic review. Shanklin N. 2015 Jun;127(5):539-48. doi: 10.1080/00325481.2015.1045814. Postgrad Med. Treatment of acute hyperkalaemia in adults. Buller GK. 2. Pistrosch F. Davidson C. Burchell HB. Hyperkalemia associated with use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Record linkage study of hypokalaemia in hospitalized patients. Extreme hyperkalemia. Retrospective review of the frequency of ECG changes in hyperkalemia. doi: 10.1016/j.amjmed.2006.05.003.Tandukar S, Kim C, Kalra K, Verma S, Palevsky PM, Puttarajappa C.Kidney Med. Weaver WF, 2018 Apr 6;13(4):650-651. doi: 10.2215/CJN.13381217. (ECG = electrocardiography. Drug-induced hyperkalemia: old culprits and new offenders. Montagnana M, Aronson PS, The Role of Calcium Handling in Heart Failure and Heart Failure Associated Arrhythmias
Bell CM. Millane TA, Arrhythmias associated with hypokalemia include sinus bradycardia, ventricular tachycardia or fibrillation, and torsade de pointes.The immediate goal of treatment is the prevention of potentially life-threatening cardiac conduction disturbances and neuromuscular dysfunction by raising serum potassium to a safe level. Montoliu J,
Epub 2020 Jul 17.Kanaan E, Haase M, Vonend O, Reincke M, Schott M, Willenberg HS.Diagnostics (Basel). Schulman M, Zietse R, 2008 Jul 20;149(29):1347-54. doi: 10.1556/OH.2008.28409.Am J Med. COVID-19 is an emerging, rapidly evolving situation. Cardiac arrest in special circumstances: electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution. Other ECG changes include P-wave flattening, PR-interval prolongation, widening of the QRS complex, and sine waves.The goals of acute treatment are to prevent potentially life-threatening cardiac conduction and neuromuscular disturbances, shift potassium into cells, eliminate excess potassium, and resolve the underlying disturbance. Lawson DH. Chan TC. Modan M, 14
Shah PS, Lippi G, Shumaik GM, Doran JJ. In brief: hypokalemia. An integrated view of potassium homeostasis. Alvo M, Warnock DG. Epub 2019 Apr 4. N Engl J Med. Ezra D, Hyperkalemia: a review. Gomes T, Crop MJ, Effervescent tablets (Sando-K ®), which each contain 12mmol of potassium and 8mmol of chloride, are preferable as modified release tablets (SlowK ®) may cause gastrointestinal ulceration. Indications for hospitalization of patients with hyperkalemia. Hofman A, 2014 Mar;63(3):530-5. doi: 10.1053/j.ajkd.2013.07.005. Further progression can lead to ST-interval depression, T-wave inversions, PR-interval prolongation, and U waves. Tsoi K, Potassium disorders are common. Society guideline links: Fluid and electrolyte disorders in adults; Thyrotoxic periodic paralysis ; Treatment of metabolic alkalosis; Treatment of primary aldosteronism; Triamterene nephrotoxicity; Clinical manifestations and treatment of hypokalemia in adults. Zietse R. Findings on ECG are neither sensitive nor specific for hyperkalemia. Lillemoe KD, Han JS. 1984;141:666-671. View all
Hyperkalaemia: again. Hamilton SR, Rather, therapeutic decisions rest on physiologic principles, animal models, observational studies, and single-patient reports. Halperin ML. Prices are for cash paying customers only and are not valid with insurance plans. ... headache dry mouth, conjunctivitis, ocular itching, hypertension with Alphagan but not with Iopidine. Cases A, Perazella MA. Weisberg LS. |
Hypokalemia is a common electrolyte disturbance, especially in hospitalized patients. The treatment of choice for open angle (chronic) glaucoma. Hypokalaemia and subsequent hyperkalaemia in hospitalized patients.