potassium disorders

Question 1

dose of IV furesomide

Answer 1

20-40mg IV every 6 hours

faster than oral

Question 2

IV insulin dose

Answer 2

IV 5-10 units every 6 hours

Question 3

how much does insulin reduce K

Answer 3

reduces K by 0.6-1 mEq lasting for 2 hours

Question 4

Dose for D10 and D50

Answer 4

D10 —> 1,000 ml (100g) > IV over 1-2 hours every 6 hours

D50: 50 mL (25g) IV over 5 mins every 6 hours

Question 5

dosing of sodium bicarbonate

Answer 5

50-100 mEq IV over 2-5 minutes every 6 hours

Question 6

when is sodium bicarbonate not effective

Answer 6

in cases that aren’t acidosis and in ESRDA PTs

Question 7

moa of sodium bicarbonate

Answer 7

its used in hyperkalemia to shift K into the cell by increasing extracellaulr pH

Question 8

what to monitor when giving sodium bicarbonate

Answer 8

hypernatermia and volume overload

Question 10

moa of B2 agonists

Answer 10

2 mechanisms in shifting K into the cells

1) Stimulating Na/K ATPase

2) Increase insulin secretion via pancreatic B-receptor

Question 11

dosing of albuterol

Answer 11

nebulized: 10-20 mg over 10 mins every 1-2 hours

Question 12

how much does albuterol reduce K

Answer 12

10 mg - reduces K by 0.6 mEq

20 mg - reduces K by 1 mEq

note that for hyperkalemia 4 or more times the dose is needed in bronchospasm

Question 13

brand name for SPS

Answer 13

kayexalate

Question 14

dose for SPS

Answer 14

15-60 g in 33% sorbitol

prefered over 70% due to GI risk

1 hour onset, repeated every 4 hours

Question 15

considerations for SPS

Answer 15

Drug-drug interactions: It can bind to oral meds therefore separate by 3 or more hours

• it has high sodium content - can contribute to volume overload

Question 16

risk factors of SPS

Answer 16

Colonic necrosis , GI toxicity

GI surgery , bowel dysfunction

avoid using it rectally in pts with bowel dysfunction

thats why its not used chronically it can lead to these

Question 17

brand name for patriomer

Answer 17

Veltassa

Question 18

dose for partriomer

Answer 18

8.4 - 25.2 g orally once daily

Question 19

side effects of patiromer

Answer 19

constipation , diarrhea , HYPOMAGNESMIA

Question 20

moa of veltessa

Answer 20

works in the distal colon

exchanges Ca for K

delayed onset

Question 21

sodium zirconium cyclosiliate

Answer 21

rapid onset (within 1 hour) but not used acutely

works in the entire intestine exchanges Na and H for K

Question 22

dosing of ZS-9 aka lokelma

Answer 22

initial: 10 g three times daily for 48 hours

maintenance: 5-15 g once daily ORALLY

ESRD pts on hemodialysis : 5-15g once on non dialysis days

Question 23

effectiveness of ZS-9

Answer 23

RAPID ONSET
DOSE DEPENDENT REDUCTION - 10 g reduces K by 1 mEq
LONG LASTING up to 48 hours

Question 24

monitoring for ZS-9

Answer 24

edema due to Na retention

Question 25

how long to separate other meds from zs-9

Answer 25

2 hours ( shorter than sps and veltessa)