K ,Ca, Mg and PO4

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Electrolyte disorders (Part 2)
Sam Adeyiga
Karteikarten von Sam Adeyiga, aktualisiert more than 1 year ago
Sam Adeyiga
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K range 3.5 - 5.0 mEq/L
Mg range 1.4 - 2.0 mEq/L
Ca2+ range 8.5 - 10.5 mg/dL (ionized 3.4 - 4.2 mg/dL)
PO4 range 2.6 - 4.5 mg/dL
Hypokalemia (check Mg Level) Severe hypokalemia = < 2.5 mg/dL
Hypokalemia treatment 1. Dietary modification 2. Oral replacement 3. IV replacement 4. NTE 10 mEq/hr 5. 20 mEq = increase of 0.25 mEq/L
Hyperkalemia treatment 1. Stabilize the heart => Give Calcium Chloride => Give Calcium gluconate 2. Move K into cells => Give Insulin + D50 => Give Albuterol => Give Na bicarb 3. Move K out of the body => Give furosemide => Give SPS => do dialysis
Hypomagnesemia treatment 1. Give Mg Oxide by mouth => up to 4 days tp equilibrate 2. Give Mg Sulfate IV => Up to 48 hrs to equilibrate
Hypermagnesemia treatment 1. Reduce intake of Mg => discontinue sources, educate pt 2. Enhance elimination => Give furosemide + IV fluid => give dialysis 3. Stabilize the heart => Give Calcium chloride => Give Calcium Gluconate
Hypocalcemia treatment 1. Check Mg level 2. Give Oral replacement => Give elemental Ca, 1 - 3 g per day 3. Give Calcium Gluconate IV
Hypercalcemia 1. Furosemide + IV fluid (1st line of therapy) 2. Biphosphonates => 2nd line of treatment => Given to out patient => Given to cancer patient 3. Calcitonin => Adjuvant therapy
Hypophosphatemia treatment 1. Give oral replacement => check Na and K levels 2. Give IV replacement => Check Na and K level
Hyperphosphatemia treatment 1. Give Ca based phosphate binder => Give Ca carbonate => Give Ca Acetate => NTE 1500 mg/day elemental Ca => Ca * P = < 55 2. Non-Ca phosphate binder => Give Sevelamer => Give Lanthanum
Hyperkalemia drugs 1. Sodium Polystrene Sulfonate (SPS) [Kayexalate] 2. Patiromer [Veltassa] 3. Sodium Zirconium cyclosilicate (SZC) [Lokelma] 4 Furosemide 5. Insulin and Glucose 6. Albuterol 7. Sodium bicar
Side effects of SPS 1. Hypomagnesemia 2. Hypocalcemia
Side effects of Patiromer 1. Constipation 2. diarrhea 3. Nausea 4. Abdominal discomfort 5. Flatulence 6. Hypomagnesemia
Onset of action of Patiromer is -------? 7 hours
Separate Patiromer from other oral medication by a period of -------- hrs 3 hours
Onset of SPS is -------hrs, and doses may be repeated every ------ hrs 1. 1-2 hrs 2. 4 hrs
What is the effect of renal impairment and hepatic impairment on SZC metabolism? SZC is not absorbed systematically, hence real and hepatic impairment do not have any effect on the drug
What is the primary adverse effect of SZC? Edema
What are the oral therapy for hypokalemia? 1. Potassium bicarb (for pt w/ metabolic acidosis) 2. Potassium chloride (mostly used for hypoK patients)
Before you treat hypokalemia, what do you have to do first? Check the Mg level first because you might need to correct the Mg at the same time.
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