hyperkalemia won
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31 Terms
why should you treat hyperkalemia
can cause hemolysis
symptoms of hyperkalemia
muscle cramps
urine abnormalities
respiratory distress
decreased contractility
EKG changes
reflex
how would hyperkalemia appear on EKG
wide flat p wave
peaked t wave
PR prolongation
widened QRS
what are some causes of acute hyperkalemia
missing dialysis
AKI
drug induced
management of chronic CKD
potassium binders
dialysis (if already on dialysis)
cation exhcangers/potassium binders
sodium polytyrene sulfonate/kayexalate
pitirome/veltassa
sodium zirconium cyclosilicate/lokelma
first line for chronic hyperkalemia
potassium binder
potassium binder indication
chronic or adjunct to insulin if acute on chronic
first line for acute hyperkalemia
insulin
sodium polystyrene sulfonate MOA
bind to K exchanges Na in colon
sodium polystyrene sulfonate ADR
hypoCa 2+, hypoK
gi obstruction
necrosis
patiromer MOA
binds to K and exchanges for Ca
patiromer ADR
hypomagnesemia
constipation
which should you not add to heated foods
patiromer
how long do you have to wait for co administration of medications with potassium binders
sodium polystyrene sulfonate = 3 hours
pitiromer = 3 hours
sodium zirconium cyclosilicate = 2 hours
sodium zirconium cyclosilicate MOA
binds to K in exchange for H and Na
sodium zirconium cyclosilicate ADR
edema
counseling for pitiromer
powder does not dissolve
acute hyperkalemia treatment
IV calcium
Albuterol
Bicarbonate
insulin
glucose
k binders
dialysis
insulin regular dose
5-10 units IVP with 25-50 g D50W if BG < 250
sodium bicarbonate indication
adjunct to insulin caused by metabolic acidosis/toxins
albuterol indication
adjunct to insulin given in ambulance
iv calcium purpose
stabilizes cardiac membrane
what managements lead to intracellular shift
insulin sodium bicarb albuterol
what method increases potassium excretion
diuretics
what method promotes physical removal of potassium
dialysis
Calcium IV products
chloride > gluconate
3 times more calcium
calcium chloride admin
central line unless in cardiac arrest
calcium gluconate admin
IV
which potassium binder can be used for acute
sodium polystyrene sulfonate
sodium zirconium cyclosilicate
diuretic indication Acute
adjunct if good renal function