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diagnosis hyperkalemia nephrology causes treatment high algorithm comparison hematology hypokalemia pathophysiology product reactions rhabdomyolysis criticalcare druginduced effects foamed gitelman lactated
Mechanisms of Drug-Induced Hyperkalemia • Direct renin inhibitor (Aliskiren) • Renin release inhibition (NSAIDs, Beta-Blockers)
• Increased EC shift ... Benyzlpenicillin, blood ... #hyperkalemia #differential ... pathophysiology #pharmacology ... #potassium #medications
Hyperkalemia Treatment Options Stabilize cardiac membrane: • IV Calcium (peaks 5-10 minutes) Decrease potassium concentration: • IV Fluids Shift
minutes) Decrease potassium ... • IV Fluids Shift ... potassium intracellularly ... peaks 1-2h) • Blood ... #Hyperkalemia #management
Hyperkalemia - Management Algorithm • IV calcium • IV insulin and glucose and/or salbutamolt • Consider
Hyperkalemia - Management ... • Consider K+ binder ... Dialysis Serum potassium ... blocks, QRS axis shift ... #hyperkalemia #potassium
Potassium Binders for Management of Hyperkalemia • SPS - Sodium polystyrene sulfonate • Patiromer (veltassa) •
Potassium Binders ... for Management ... cyclosilicate #Potassium ... #Binders #Management ... Hyperkalemia #treatment #pharmacology
Lactated Ringers (LR) vs Normal Saline (NS) - Comparison Composition of LR: • Sodium 130 mEq/L •
130 mEq/L • Potassium ... Can give with blood ... - Citrate in blood ... transcellular shift ... NS #comparison #pharmacology
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
Hyperkalemia - Differential ... Crush injury • Blood ... • Recent IV potassium ... Intracellular Shift ... Blood transfusion
Algorithm for patients with hypokalemia on the basis of the potassium-to-creatinine ratio in the urine Urine K+
the basis of the potassium-to-creatinine ... creatinine) • Cell shift ... effective arterial blood ... hypokalemia #urine #potassium ... #differential #
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
Hyperkalemia - Differential ... Crush injury • Blood ... • Recent IV potassium ... Intracellular Shift ... Blood transfusion
Rhabdomyolysis - Differential Diagnosis Framework and Management Summary Causes of Rhabdomyolysis: • Trauma: - Immobilization - Crush injury - Compartment
Rhabdomyolysis - Differential ... Framework and Management ... UA positive for blood ... Shift of extracellular ... Monitor potassium
Rhabdomyolysis - Differential Diagnosis and Management Summary Trauma: • Immobilization, Crush iniury, Compartment syndrome, Electrical injury Exertional: •
Rhabdomyolysis - Differential ... Diagnosis and Management ... Shift of extracellular ... Monitor potassium ... #Diagnosis #Management
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