MICU intern's survival guide hyperkalemia treatment
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Hyperkalemia Microchapters |
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Diagnosis |
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Treatment |
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Overview
Treatments based on rapidity of action
Treatment based on rapidity of action (fastest to slowest). The choice of therapy also depends on severity of ECG findings and muscle weakness.
Calcium supplements
- Calcium supplements given only in hyperkalemia with significant EKG findings.
- Calcium stabilize cardiac membranes thus antagonizing effects of potassium.
- Calcium chloride 0.5 to 1 grams (5-10 ml of 10% solution) via intravenous infusion over 2-3 minutes (central lines are preferred)
- Calcium gluconate 1 gram (10 mL of 10 % solution) infused slowly. Peripheral as well as central lines can be used.
- Repeat calcium after 5 minutes for persistent EKG changes.
- Patient should be on cardiac monitor when calcium is administered.
- Calcium can increase digoxin toxicity.
- It has a transient effect so calcium therapy should be combined with other long effect therapy.