Hypokalemia: Difference between revisions
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*Shift | *Shift | ||
**Alkalosis (each 0.10 rise in pH causes 0.5 decrease) | **Alkalosis (each 0.10 rise in pH causes 0.5 decrease) | ||
**Insulin | **[[Insulin]] | ||
**B-agonist | **B-agonist | ||
*Decreased intake | *Decreased intake | ||
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***Hyperaldo | ***Hyperaldo | ||
**Exercise | **Exercise | ||
***HyperCa | ***[[HyperCa]] | ||
***HypoMg | ***[[HypoMg]] | ||
*Drugs | *Drugs | ||
**PCN | **PCN | ||
**Lithium | **[[Lithium]] | ||
**L-dopa | **L-dopa | ||
**Theophyline | **Theophyline | ||
Revision as of 07:08, 18 December 2013
Background
- Low = <3.5meq/L
- Low! = <2.5meq/L
Clinical Features
- CNS
- Weakness
- Cramps
- Hyporeflexia
- GI
- Ileus
- Renal
- Met alkalosis
- 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
DDX
- Shift
- Alkalosis (each 0.10 rise in pH causes 0.5 decrease)
- Insulin
- B-agonist
- Decreased intake
- Increased loss
- Drugs
- PCN
- Lithium
- L-dopa
- Theophyline
Treatment
- 20meq/hr KCl IV or PO
- every 10meq should inc serum by ~0.1meq/L
- Treat hypomag if present
- Usual dose is 40meq IV or PO unless level is <2.5. If so, both forms should be given
- 10meq will raise serum level by 0.1
- Intravenous K+ typically runs at 10meq/hour, burns when infused, and may cause phelbitis/sclerosis if run faster
- Oral K+ more quickly absorbed and preferred
- KCl elixir easily swallowed, but tastes terrible, KDur oral tablet is large and hard to swallow
See Also
Electrolyte Abnormalities (Main)
Source
- Tintinalli