Hypokalemia

Hypokalemia

  • Signs/symptoms: muscle weakness, cramps, N/V, polyuria, EKG changes, arrhythmias, increase in pH & bicarb
  • Causes: HI loss (D/V), renal losses (high aldosterone, low Mg), inadequate intake, alkalosis, meds (beta-2 agonists, insulin, diuretics, corticosteroids, high dose antibiotics, amphotericin B, cisplatin, foscarnet, aminoglycosides)
  • Trxt: potassium repletion should involve close monitoring of levels rather than using a predetermined amount
    • Potassium acetate, potassium chloride
    • Moderate hypokalemia w/o EKG changes trxt:
      • Oral: 40-120 mEq/day
        • If you want a rapid response, use liquid or powder instead of the controlled-release product
    • Severe hypokalemia &/or EKG changes
      • IV replacement: max infusion rate = 40 mEq/hr (central line)                 max concentration = 80 mEq/L
        • Can cause thrombophlebitis in peripheral vein
          • Max rate of infusion in peripheral vein = 10 mEq/hr
        • Correct Mg deficits at the same time

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