Chapter 109 Potassium disorders

Question 1

Dr. Harris’dog has severe hypoK and ventricular tachycardia. She knows that dogs are sensitive to lidocaine and is treating her dog with 0.25mg.kg IV lidocaine. Is this a good or bad idea?

Answer 1

HypoK makes the myocardium refractory class I (lidocaine). The lidocaine will likely not work. Its ok to try, but more important to correct the potassium asap.

Question 2

Hocine has an extremely hypoK patient that is going to code any minute from low potassium. What is the ABSOLUTE max rate of potassium supplementation if the patient is closely monitored?

Answer 2

In profoundly hypokalemic patients, the rate can cautiously be increased to 1.0–1.5mEq/kg/h long as close ECG monitoring is available

Question 3

What is max K concentration to give in peripheral IVC in humans?

Answer 3

60mEq/L

Question 4

What are the recommendations regarding K supplementation and dehydration

Answer 4

Wait with supplementation until rehydrated, unless severely hypoK.

Question 5

Why does hypoK animals show signs of pu/pd?

Answer 5

Decreased response to ADH

Question 6

With time K will build up in stored RBC products. Is it T/F that the amount of K in the bag can reach so high levels that fatal hyperK can develop during transfusion?

Answer 6

• True, one case report.
• Especially if the blood is donated from a puppy or an asian breed. These dogs have a great functional NaKATPase pump in their RBC which cause intracellular K accumulation.

Question 7

How does terbutaline work when used in hyperK?

Answer 7

Increase intracellular shift of K