Hyper and Hypokalemia Flashcards
What are the categories of hyperkalemia?
Worry about EKG changes. Urgently refer anyone greater than 6 with or without EKG changes. Absolute change in K isn’t the problem; it’s the rapidity of getting there
What sampling errors can happen in measuring hyperkalemia?
Pseudohyperkalemia. Not hemolyzed sample, but if cells get damaged during collection, then there is extra K in the sample. “tough stick” could mean that K will be elevated. Vein trauma, serum separator tube with clot in it. If you send a “whole blood sample” there will be an anti-coagulant in the tube, no clot, no extra potassium leaking out – whole blood K
Name 3 high K foods
Oranges, avocado, melon, raisins, dates, banana
Why is a high potassium diet beneficial
High potassium diet linked to lower BP. Eat lots of potassium, inactivate thiazide channels. Low potassium diet, worsening BP control. Fruits and veggies increase alkalai, improves metabolic acidosis.
What foods might be contributing to hyperkalemia
Watch out for salt substitutes. Sauces, juice, smoothies
What disease states can make hyperkalemia worse?
Hyperkalemia can be made worse by Constipation and fasting (because of low insulin)
What drugs should can contribute to hyperkalemia
NSAIDs – can cause hyperkalemia, even without AKI
Secretes renin (something)
Less renin, less aldosterone, less excretion of K
Antibiotics – Bactrim
Blocks K excretion
What is the relationship between diabetes and hyperkalemia?
Patients with diabetes are more likely to have hyperkalemia. Have less insulin, more insulin resistance. Insulin surge after a meal is less robust, less shift into cells. Then, some are in low renin, low aldosterone state. Low aldosterone is less efficient in excreting K
Name facts about SPS
kayexylate
Rare ADRs
Patients do not like; tastes terrible
Name some facts about patiromir
Effective in lowering to normal levels
Able to stay on ARBs, ACEI, MRAs
ADRs Hypomagnesium, constipation
Name some facts about Sodium Zirconium (SZC)
Works fast, potassium reduction in 2.2h
Sodium in product, can cause edema
Sodium doesn’t increase BP
Tasteless
