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Pharm > Electrolytes > Flashcards

Electrolytes Flashcards

1
Q

Sodium (normal range)

A

136-154 mEq/L

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2
Q

Euvolemic hypotonic hyponatremia
(normal: 136-154)

A

(SIADH - increase urine Na secretion)
1. Demeclocycline
2. Vasopressin receptor antagonists (tolvaptan, conivaptan)

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3
Q

Euvolemic hypernatremia
(normal: 136-154)

A

(diabetes insipidus - inability to concentrate urine with Na)
1. desmopressin
(nephrogenic diabetes insipidus - no response to ADH by kidneys)
1. HCTZ
2. Indomethacin
3. amiloride

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4
Q

Hypervolemic hypernatremia
(normal: 136-154)

A

Diuretics
+/- hypotonic saline or D5W

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5
Q

Calcium (normal range)

A

8.5-10.8 mg/dL

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6
Q

Hypocalcemia
(normal: 8.5-10.8)

A

Calcium supplements

Calcium carbonate > chloride > acetate > citrate > gluconate

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7
Q

Hypocalcemia (etiology)

Reg by PTH, vitamin D

A
  1. hypoalbuminemia
  2. hypomagnesemia
  3. hyperphosphatemia
  4. renal insuff
  5. hypoPTH
  6. vitamin D def
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8
Q

Hypercalcemia (etiology)

Reg by PTH, vitamin D

A
  1. malignancy (e.g. cancer)
  2. hyperthyroidism
  3. bone disease
  4. medications: thiazides, excessive vitamin D, hormones, lithium
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9
Q

Hypercalcemia

A
  1. NS infusion
  2. furosemide IV
  3. pamidronate
  4. zoledronic acid
  5. calcitonin
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10
Q

Phosphate (normal range)

A

2.7-4.5 mg/dL

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11
Q

Hypophosphatemia
(normal: 2.7-4.5)

A
  1. K-phos neutral
  2. IV phosphorus
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12
Q

Hypophosphatemia (etiology)

Lipid & carb metabolism, ATP formation, DNA; reg by kidney & PTH

A
  1. malnutrition
  2. alcoholism
  3. vomitting
  4. CRRT
  5. diuretics
  6. antacids, sucralfate
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13
Q

Hyperphosphatemia (etiology)

Lipid & carb metabolism, ATP formation, DNA; reg by kidney & PTH

A
  1. tumor lysis syndrome
  2. rhabdomyolysis
  3. hypoPTH
  4. vitamin D toxicity
  5. renal impairment
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14
Q

Hyperphosphatemia
(normal: 2.7-4.5)

A
  1. calcium acetate > carbonate - preferred in CKD (but NOT citrate)
  2. aluminum hydroxide - reserved for Phos >7, no good for CKD
  3. magnesium hydroxide
  4. sevelamer
  5. lanthanum carbonate
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15
Q

Normal range

Potassium

Intracellular

A

3.5-5.0 mEq/L

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16
Q

Etiology

Hypokalemia

Reg by kidney

A
  1. Inadq intake (starvation, anorexia, alcoholism)
  2. transcellular shift (alkalosis, refeeding syndrome, dextrose, DKA tx)
  3. Excessive loss (V/D, hypomag)
  4. Med induced (insulin, B-agonists, PDE-i, levothyroxine, thiazides, loops, AG, cisplatin, amphotericin)
17
Q

Treatment

Hypokalemia

Normal: 3.5-5.0

A
  1. Potassium supplements (most common: chloride)
18
Q

Etiology

Hyperkalemia

Reg by kidney

A
  1. acidosis
  2. HF, renal insuff
  3. ACEi/ARBs
  4. K-sparing diuretics
  5. NSAIDs
  6. heparin
  7. non-selective BB
19
Q

Treatment

Hyperkalemia

Normal: 3.5-5.0

A
  1. calcium gluconate
  2. insulin + dextrose
  3. sodium bicarb
  4. albuterol
  5. sodium polystyrene sulfonate (SPS, Kayexalate)
  6. patiromer (Veltessa)
  7. sodium zirconium (Lokelma)
  8. hemodialysis
20
Q

Normal range

Magnesium

A

1.8-2.5 mg/dL

21
Q

Etiology

Hypomagnesemia

Carb & protein metab; reg by kidney and GI

A
  1. “Refeeding syndrome”
  2. V/D
  3. alcoholism
  4. Renal insuff + meds
  5. CRRT
22
Q

Treatment

Hypomagnesemia

Normal: 1.8-2.5

A
  1. Mag supplements (IV - sulfate, PO - slow onset)
23
Q

Etiology

Hypermagnesemia

Carb & protein metab; reg by kidney and GI

A
  1. renal insuff
  2. dec GI motility (inc GI absorption) - constipation, bowel obstruction, GI perforation
  3. Mg supplements, antacids
24
Q

Treatment

Hypermagnesemia

Normal: 1.8-2.5

A
  1. NS
  2. Loops
  3. Calcium IV (chloride, gluconate)
  4. Hemodialysis

Pharm (7 decks)

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