Drugs for Hypo/Hyperkalemia Flashcards

1
Q

At what plasma level of K is hyperkalemia

A

> 5.2 mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

At what plasma level of K is hypokalemia

A

< 3.7 mEq/L`

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

in acidemia does K move in or out of the cell?

A

K+ moves out to exchange with H+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

in alkalemia does K move in or out of the cell

A

K+ moved in to exchanged with H+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which factors move Potassium out of the cell

A
a-Agonist 
Insulin deficiency 
Aldosterone 
B2-Blockers 
Acidosis 
Hyperosmolarity 
Exercise 
Cell Lysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What factors move potassium into the cell

A
Insulin***
B2-Agonist 
Aldosterone deficiency 
a-blockers 
Alkalosis 
Hypoosmolarity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the overall effect of high sodium diet on K homeostasis

A

No net change

increase Na decreases aldosterone -> no K secretion
increase Na increases GFR -> increase K secretion

balances out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the effect of hypokalemia on tissue membrane polarization

A

hyperpolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the effect of hyperkalemia on tissue membrane polarization

A

depolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the MOA of furosemide

A

Blocks Na-K-Cl cotransporter in loop of henle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the adverse effects of furosemide

A

hypokalemia, hyponatremia, hypocalcemia, hyperglycemia, hyperuricemia, ototoxic, sulfonamide allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If you wanted a loop diuretic with a longer half life and better oral absorption what drugs would you pick

A

torsemide

bumetanide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

if you wanted a loop diuretic to bypass the sulfa allergy, what drug would you pick

A

ethacrynic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the MOA of HCTZ

A

blocks Na-Cl cotransporter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If you wanted a thiazide diuretic with a longer half-life than HCTZ what drug would you pick

A

Chlorthalidone

metolazone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the MOA of Amiloride

A

Blocks ENAc in the collecting ducts, counteracts K loss

17
Q

What are the toxicities of Amiloride

A

Hyperkalemia, hyponatremia, hypovolemia

triamterene alternative

18
Q

What is the MOA of spironolactone

A

Aldosterone receptor blocker and partial agonist at androgen receptor

19
Q

What are the toxicities of spironolactone

A

hyperkalemia, amenorrhea, hirsutism, gynecomastia

eplerenone: is more selective for aldosterone

20
Q

What is the major concern when using witch craft alternative diuretics such as dandelion leaves, fennel or St john wort

A

potential drug interactions that will diminish or enhance the actions of other drugs.

21
Q

If you have a patient with Acidemia, Normal Anion Gap, and Normal serum Creatinine. What does that patient have?

A

Renal Tubular Acidosis

22
Q

hypokalemia mneumonic

A

GRAPHIC IDEA

GI Loss
Renal Tubular Acidosis (type I and II)
Aldosterone
Paralysis 
Hypothermia
Insulin Excess
Cushing Syndrome

Insufficient Intake
Diuretics
Elevated B-adrenergic activity
Alkalosis

23
Q

What are the goals of the treatment of hypokalemia

A
  • Prevent life threatening conditions
  • Replace K+ deficit
  • Diagnose underlying cause
24
Q

In the treatment of hypokalemia, what is the amount needed to to replace acute and chronic hypokalemia

A

acute: 100mEq -> increase .27 mEq/L

Chronic: 200-400 mEq -> 1 mEq/L

25
What is the hyperkalemia mnemonic
RED FETS Renal Disease Excessive Intake Drugs Factitious Endocrine (addisons) Tissue Release Shifts out of cell
26
What are the three categories of treatment of hyperkalemia?
Antagonize cardiac effects - give Ca Redistribute K into cells -> insulin and glucose, B2-agonist Facilitate K+ elimination - K losing diuretic