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diagnosis hyperkalemia management differential nephrology causes treatment algorithm comparison hematology medications pathophysiology product reactions anesthesia anesthesiology binding cardiac checklist digoxin
Potassium-Binding Agents to Treat Hyperkalemia Sodium zirconium cyclosilicate (Lokelma): • Mechanism: Preferentially captures K in exchange for
Potassium-Binding ... nonspecifically binds ... patients sensitive to high ... of aspiration #Potassium ... #medications #pharmacology
Algorithm for patients with hypokalemia on the basis of the potassium-to-creatinine ratio in the urine Urine K+
patients with hypokalemia ... the basis of the potassium-to-creatinine ... creatinine) • Cell shift ... effective arterial blood ... #urine #potassium
Mechanisms of Drug-Induced Hyperkalemia • Direct renin inhibitor (Aliskiren) • Renin release inhibition (NSAIDs, Beta-Blockers)
of Drug-Induced Hyperkalemia ... • Increased EC shift ... Benyzlpenicillin, blood ... pathophysiology #pharmacology ... #potassium #medications
Hyperkalemia - Management Algorithm • IV calcium • IV insulin and glucose and/or salbutamolt • Consider
Hyperkalemia - Management ... • Consider K+ binder ... and ECG changes ... blocks, QRS axis shift ... #potassium #high
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
phlebotomy High ... Crush injury • Blood ... Intracellular Shift ... Blood transfusion ... #high #nephrology
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
phlebotomy High ... Crush injury • Blood ... Intracellular Shift ... Blood transfusion ... #high #nephrology
Digoxin Pharmacology and Pathophysiology 1) Na/K ATPase Pump - Digoxin works by directly binding to and inhibiting
Digoxin Pharmacology ... - Hyperkalemia ( ... high potassium levels ... Because digoxin binds ... Pathophysiology #cardiology
Lactated Ringers (LR) vs Normal Saline (NS) - Comparison Composition of LR: • Sodium 130 mEq/L •
130 mEq/L • Potassium ... Is Dangerous in Hyperkalemia ... transcellular shift ... densa receives high ... NS #comparison #pharmacology
Hyperkalemia Management Pseudohyperkalemia: 1. Hemolyzed sample 2. Blood drawn from a site/line where potassium or TPN is
Hyperkalemia Management ... Blood drawn from ... • Order a STAT EKG ... minutes-hour) -Shift ... #high
Rhabdomyolysis - Differential Diagnosis Framework and Management Summary Causes of Rhabdomyolysis: • Trauma: - Immobilization - Crush injury - Compartment
• LDH ↑ • Hyperkalemia ... UA positive for blood ... Shift of extracellular ... fluid/Lactated ringers ... Monitor potassium
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