Reference Ranges, Potassium and Sodium

Electrolyte ranges: Calcium

2.20 - 2.60 mmol/L

Electrolyte ranges: Magnesium

0.60 - 1.00 mmol/L

Electrolyte ranges: Phosphate

0.87 - 1.45 mmol/L

Electrolyte ranges: Potassium

3.5 - 5.3 mmol/L

Electrolyte ranges: Sodium

133 - 146 mmol/L

Drugs that cause hypokalaemia

Aminophylline/Theophylline. Beta agonists. Corticosteroids. Diuretics (Loop/Thiazides). Erythromycin/Clarithromycin. Insulin. (Remember ABCDE I)

Drugs that cause hyperkalaemia

Trimethoprim. Heparins. ACE-i/ARBs. NSAIDs. K-Sparing Diuretics. Beta blockers. (Remember THANKS, B)

Hypokalaemia predisposes patients taking digoxin to what condition?

Digoxin toxicity

Potassium imbalance leads to what sort of side-effects?

Cardiac side-effects (e.g. arrhythmias)

Treatment for mild-moderate hypokalaemia

Oral replacement therapy (Sando-K tablets)

Treatment for severe hypokalaemia

IV KCL in NaCl

Lab result for acute severe hyperkalaemia

>6.6mmol/L

Treatment for severe acute hyperkalaemia

IV calcium chloride 10%/calcium gluconate 10%. IV soluble insulin (5-10 units) with 50mL glucose 50% given over 5-15mins. Salbutamol (nebulisation or slow IV injection).

Treatment for Mild-moderate hyperkalaemia

Ion-exchange resins to remove excess potassium (Calcium Resonium)

Drugs that cause hyponatremia

Carbamazepine. Diuretics. Desmopressin/Vasopressin. SSRIs. (Remember Certain Drugs Ditch Salt)

Drugs that cause hypernatremia

Sodium bicarbonate/chloride. Corticosteroids. Effervescent formulations. Oestrogens/androgens. (Remember Salty CEO)

Treatment for hyponatraemia

Mild-moderate: oral supplements (sodium bicarbonate/chloride). Severe: IV NaCl.