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Key Characteristics of Old and New Potassium-Binding Agents

- Dr. Edgar V. Lerma https://twitter.com/edgarvlermamd

#Potassium #Binding #KBinders #Kayexelate
Agents - Dr. ... Kayexelate #Comparison #Table ... #Pharmacology # ... Patiromer #HyperKalemia ... #Nephrology #Agents
Hyperkalemia Treatment Options
Stabilize cardiac membrane:
 • IV Calcium (peaks 5-10 minutes)
Decrease potassium concentration:
 • IV Fluids
Shift
Hyperkalemia Treatment ... • IV Fluids Shift ... function) - Loop diuretic ... #management #potassium ... #nephrology
Summary of Diuretic Agents 
Subclass, Drug, Mechanism of Action, Effects, Clinical Applications, Pharmacokinetics, Toxicities, Interaction
CARBONIC ANHYDRASE
Agents Subclass ... Chlorthalidone POTASSIUM-SPARING ... #Medications #Pharmacology ... #summary #table ... #nephrology
Algorithm for patients with hypokalemia on the basis of the potassium-to-creatinine ratio in the urine
Urine K+
creatinine) • Cell shift ... Urine Cl - Loop diuretics ... , Thiazide diuretics ... #urine #potassium ... algorithm #diagnosis #nephrology
Potassium Binders for Management of Hyperkalemia
 • SPS - Sodium polystyrene sulfonate
 • Patiromer (veltassa)
 •
Potassium Binders ... for Management ... treatment #pharmacology ... #table #comparison ... #nephrology
Hyperkalemia Management Algorithm
 • Treat the cause & optimize hemodynamics and ventilation
 • Reconsider treatment leadingto
Hyperkalemia Management ... • Reconsider treatment ... Intracellular K+ Shift ... #treatment #potassium ... #high
Potassium-Binding Agents to Treat Hyperkalemia
Sodium zirconium cyclosilicate (Lokelma):
 • Mechanism: Preferentially captures K in exchange for
Potassium-Binding ... Agents to Treat ... patients sensitive to high ... #medications #pharmacology ... #table #comparison
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
phlebotomy High ... • K sparing diuretics ... • Recent IV potassium ... Intracellular Shift ... #high #nephrology
Hyperkalemia - Management Algorithm
 • IV calcium
 • IV insulin and glucose and/or salbutamolt
 • Consider
Hyperkalemia - Management ... Dialysis Serum potassium ... blocks, QRS axis shift ... #potassium #high ... #algorithm #treatment
Hyperkalemia - Diagnosis and Management - GrepMed Handbook

S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
and Management ... clear cause) Management ... Elimination (see Table ... #Treatment #potassium ... #nephrology #K