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hyperkalemia differential treatment high nephrology algorithm hematology medications product reactions rhabdomyolysis table binding criticalcare crystalloids druginduced effects evaluation foamed lactated
Potassium-Binding Agents to Treat Hyperkalemia Sodium zirconium cyclosilicate (Lokelma): • Mechanism: Preferentially captures K in exchange for
Potassium-Binding ... of aspiration #Potassium ... #medications #pharmacology ... #table #comparison ... #binders
Potassium Binders for Management of Hyperkalemia • SPS - Sodium polystyrene sulfonate • Patiromer (veltassa) •
Potassium Binders ... for Management ... #Binders #Management ... treatment #pharmacology ... #table #comparison
Mechanisms of Drug-Induced Hyperkalemia • Direct renin inhibitor (Aliskiren) • Renin release inhibition (NSAIDs, Beta-Blockers)
• Increased EC shift ... Benyzlpenicillin, blood ... #differential #diagnosis ... pathophysiology #pharmacology ... #potassium #medications
Hyperkalemia - Management Algorithm • IV calcium • IV insulin and glucose and/or salbutamolt • Consider
Hyperkalemia - Management ... • Consider K+ binder ... blocks, QRS axis shift ... #potassium #high ... #diagnosis #management
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
Diagnosis Framework ... Crush injury • Blood ... Intracellular Shift ... Blood transfusion ... #causes #potassium
Lactated Ringers (LR) vs Normal Saline (NS) - Comparison Composition of LR: • Sodium 130 mEq/L •
Saline (NS) - Comparison ... 130 mEq/L • Potassium ... Is Dangerous in Hyperkalemia ... transcellular shift ... #pharmacology #
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
Diagnosis Framework ... Crush injury • Blood ... Intracellular Shift ... Blood transfusion ... #causes #potassium
Rhabdomyolysis - Differential Diagnosis Framework and Management Summary Causes of Rhabdomyolysis: • Trauma: - Immobilization - Crush injury - Compartment
Summary Causes ... UA positive for blood ... Shift of extracellular ... Monitor potassium ... #Management #causes
Causes of Hyperkalemia Pseudohyperkalemia - Tourniquet use - Hemolysis (in vitro) - Leukocytosis - Thrombocytosis Intra- to extracellular
Causes of Hyperkalemia ... shift - Acidosis ... Transfusion of aged blood ... acidosis) #Hyperkalemia ... #Causes #diagnosis
Rhabdomyolysis - Differential Diagnosis and Management Summary Trauma: • Immobilization, Crush iniury, Compartment syndrome, Electrical injury Exertional: •
and Management ... Shift of extracellular ... Monitor potassium ... Dialysis for severe hyperkalemia ... #causes #treatment
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