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PR - BLOOD + NUTRITION > FLUID + ELECTROLYTE IMBALANCE > Flashcards

FLUID + ELECTROLYTE IMBALANCE Flashcards

1
Q

Calcium

A

2.2-2.6

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2
Q

Which electrolytes are we concerned with?

A
  • Ca
  • Mg
  • K
  • Na
  • Ph
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3
Q

Magnesium

A

0.6-1

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4
Q

Phosphate

A

0.87-1.45

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5
Q

Potassium

A

3.5-5.3

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6
Q

Sodium

A

113-146

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7
Q

K - results

A
  • Normal: 3.5 - 5.3 mmol/L
  • Hyper: >6.5 (you might see changes in ECG)
  • Нуро: <2.5
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8
Q
A
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9
Q

Hypokalaemia - side effects

A

Muscle cramps, rhabdomyolysis, fatigue, palpitations, arrhythmias

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10
Q

Hyperkalaemia - side effects

A

Fatigue, numbness, nausea, SOB, chest pain, palpitations

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11
Q

Hyponatraemia - side effects

A

Nausea, heaHypernatraemia: Thirst, fatigue, confusiondache, confusion, fatigue, irritability, seizures

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12
Q

Hypernatraemia - side effects

A

Thirst, fatigue, confusion

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13
Q

Hypocalcaemia - side effects

A

Muscle cramp, confusion, depressed, forgetful

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14
Q

Hypercalcaemia - side effects

A

Nausea, lethargy, muscle cramps, confusion, arrythmias

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15
Q

Potassium

A

Imbalance leads to cardiac side-effects such as arrythmias

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16
Q

Hypokalaemia - drugs

A

Aminophylline / Theophylline
Beta Agonists
Corticosteroids
ACE-Inhibitors / ARBs
Diuretics (Loop / Thiazides)
Erythromycin / Clarithromycin
Insulin
ABCDE I

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17
Q

Hyperkalaemia - drugs

A

Trimethoprim
Heparins
ACE-Inhibitors / ARBs
NSAIDS
K-Sparing Diuretics
Insulin
Beta Blockers
THANKS, B

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18
Q

Hypokalaemia - digoxin

A

Hypokalaemia predisposes patients taking digoxin to toxicity

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19
Q

Mild-moderate hypokalaemia treatment

A

Oral replacement therapy (Sando-K tablets)

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20
Q

Severe Hypokalaemia treatment

A

IV KCL in NaCl

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21
Q

Hypokalaemia - renal impairment

A

Potassium replaced cautiously in patients with renal impairment

Risk of hyperkalaemia secondary to impaired potassium excretion

22
Q

Acute severe hyperkalaemia

A

(plasma concentration > 6.5 mmol/litre):

23
Q

Acute severe hyperkalaemia treatment

A
  • Urgent treatment
  • IV calcium chloride 10% / calcium gluconate 10%
  • IV soluble insulin (5-10 units) with 50 mL glucose 50% given over 5-15 minutes
  • Salbutamol (nebulisation or slow IV injection)
  • Drugs exacerbating hyperkalaemia should be reviewed and stopped as appropriate
24
Q

Mild-moderate hyperkalaemia treatment

A

lon-exchange resins may be used to remove excess potassium (Calcium Resonium)

25
Q

Hyponatraemia - drugs

A

Carbamazepine
Diuretics
Desmopressin / Vasopressin
SSRIs
CERTAIN DRUGS DITCH SALT

SALTY CEO
Hyponatraemia:
Mild - moderate: oral supplements (sodium chloride or sodium bicarbonate)
Severe: IV NaCl
Copyright property of RevisePharma. Unauthorised recording and reproduction of this lecture will result in being refferred to the GPhC under copyright infringement law.
nation Classification: General
20

26
Q

Hypernatraemia - drugs

A

Sodium Bicarbonate / Chloride
Corticosteroids
Effervescent formulations
Oestrogens / Androgens
SALTY CEO

27
Q

Mild moderate Hyponatraemia - treatment

A

oral supplements (sodium chloride or sodium bicarbonate)

28
Q

Severe hyponatraemia - treatment

A

Severe: IV NaCl

29
Q

Hypocalcaemia - drugs

A

Rifampicin
Phenytoin
Phenobarbital

30
Q

Hypercalcaemia - drugs

A

Thiazide diuretics
Lithium

31
Q

Hypocalcaemia - treatment

A
  • Calcium supplements needed if dietary calcium intake is deficient
  • Osteoporosis: double recommended amount reduces rate of bone loss
  • Oral supplements of calcium given with vitamin D
32
Q

Severe acute hypocalcaemia or hypocalcaemic tetany

A
  • Initial slow IV calcium gluconate 10% with plasma-calcium and ECG monitoring
    (Arrhythmias if given rapidly)
  • Repeated if needed or follow with continuous IV infusion to prevent recurrence
33
Q

Severe hypercalcaemia

A

Correct dehydration first with IV NaCl 0.9%
Discontinue drugs which cause hypercalcaemia, restrict dietary calcium Bisphosphonates and pamidronate disodium used

34
Q

hypercalcaemia is due to sarcoidosis or vitamin D toxicity

A

Corticosteroids

35
Q

hypercalcaemia associated with malignancy

A

Calcitonin

36
Q

Hypercalciuria

A

Increase fluid intake + give bendroflumethiazide
Reducing dietary calcium intake but not severe restriction (harmful)

37
Q

Hyperparathyroidism

A

Excess parathyroid hormone → hypercalcaemia, hypophosphataemia and hypercalciuria

38
Q

Symptoms of hyperparathyroidism

A

Thirst, polyurea, constipation, fatigue, memory impairment, CVD, kidney stones and osteoporosis

39
Q

Who does parathyroidism effect more?

A

Affects twice as many women than men - most common in women aged 50 to 60 years

40
Q

Hyperparathyroidism - first line treatment

A

Parathyroidectomy surgery is the recommended first-line
Assess CVD risk and fracture risk

41
Q

Hyperparathyroidism - second line treatment

A

Cinacalcet if surgery has been unsuccessful / declined
In secondary care, measure vitamin D levels, supplement if needed
To reduce fracture risk: a bisphosphonate

42
Q

Magnesium - function

A

Essential in enzyme systems, energy generation - stored in the skeleton

43
Q

Magnesium - excreted in

A

Excreted by kidneys therefore retained in renal failure, which causes hypermagnesaemia

44
Q

Hypermagnesaemia - symptoms

A

Causes muscle weakness and arrhythmias

45
Q

Hypermagnesaemia - treatment

A

Calcium gluconate injection is used for the management of magnesium toxicity

46
Q

Hypomagnesaemia Symptomatic - treatment

A

V / IM magnesium sulfate (IM = painful)

47
Q

Hypomagnesaemia mild - treatment

A

PO magnesium

48
Q

Hypophosphataemia

A
  • In patients with alcohol dependence or severe DKA
  • Oral phosphate supplements
49
Q

Hyperphosphataemia

A

Phosphate binding agents (calcium-based or non-calcium-based preparations)

Patients with stage 4/5 CKD: manage diet + dialysis before starting agents 1st line: Calcium acetate
2a line: Sevelamer
3a line: CaCO, (calcium-based) or sucroferric oxyhydroxide (non-calcium-based)

50
Q
A

PR - BLOOD + NUTRITION (13 decks)

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