Hypokalemia: Difference between revisions
(→DDX) |
|||
| Line 25: | Line 25: | ||
[[Image:ECG Hypokalemia.jpg]] | [[Image:ECG Hypokalemia.jpg]] | ||
== | ==Differential Diagnosis== | ||
===Shift=== | ===Shift=== | ||
*Alkalosis (each 0.10 rise in pH causes 0.5 decrease) | |||
*[[Insulin]] | |||
*B-agonist | |||
===Decreased intake=== | ===Decreased intake=== | ||
*Special diets or those low in potassium | *Special diets or those low in potassium | ||
===Increased loss=== | ===Increased loss=== | ||
*GI (v/d/fistula) | |||
*Renal | |||
**Diuretics | |||
**Hyperaldo | |||
**Exercise | |||
**[[HyperCa]] | |||
**[[HypoMg]] | |||
===Drugs=== | ===Drugs=== | ||
*[[Penicillin]] | |||
*[[Lithium]] | |||
*L-dopa | |||
*Theophyline | |||
==Treatment== | ==Treatment== | ||
Revision as of 06:29, 19 January 2015
Background
- Low = <3.5meq/L
- Low! = <2.5meq/L
Clinical Features
- CNS
- Weakness
- Cramps
- Hyporeflexia
- GI
- Ileus
- Renal
- CV
- PACs/PVCs
- Bradycardia or atrial/junctional tachycardia
- AV block
- V tach, V fib
Diagnosis
- ECG findings:
- ST seg depression
- U wave (V4-V6)
- QT prolongation
Differential Diagnosis
Shift
- Alkalosis (each 0.10 rise in pH causes 0.5 decrease)
- Insulin
- B-agonist
Decreased intake
- Special diets or those low in potassium
Increased loss
Drugs
- Penicillin
- Lithium
- L-dopa
- Theophyline
Treatment
- every 10meq should inc serum by ~0.1meq/L
- If level is <2.5, both oral and IV should be given
- Typically 20meq/hr KCl IV or PO
- Oral K+
- more quickly absorbed and preferred
- KCl elixir easily swallowed, but tastes terrible
- KDur oral tablet is large and hard to swallow
- Intravenous K+
- typically runs at 10meq/hour (peripheral line)
- burns when infused, and may cause phelbitis/sclerosis if run faster
- Treat Hypomagnesemia if present
See Also
Source
- Tintinalli