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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
of Old and New Potassium-Binding ... edgarvlermamd #Potassium ... #Binding #KBinders ... Comparison #Table #Pharmacology ... #Patiromer #HyperKalemia
Potassium Binders for Management of Hyperkalemia
 • SPS - Sodium polystyrene sulfonate
 • Patiromer (veltassa)
 •
Potassium Binders ... for Management ... polystyrene sulfonate • Patiromer ... #Binders #Management ... treatment #pharmacology
Veltassa (Patiromer) 
MECHANISM: Potassium Binder 
INDICATION: Treatment of Hyperkalemia 
FORMULATION: Powder for oral suspension 
DOSING: 8.4
Veltassa (Patiromer ... Binder INDICATION ... #Potassium #Binder ... #KBinder #Hyperkalemia ... #Pharmacology
Potassium-Binding Agents to Treat Hyperkalemia
Sodium zirconium cyclosilicate (Lokelma):
 • Mechanism: Preferentially captures K in exchange for
Potassium-Binding ... Patiromer (Veltassa ... nonspecifically binds ... of aspiration #Potassium ... #medications #pharmacology
Mechanisms of Drug-Induced Hyperkalemia 
 • Direct renin inhibitor (Aliskiren)
 • Renin release inhibition (NSAIDs, Beta-Blockers)
• Increased EC shift ... Benyzlpenicillin, blood ... #differential # ... pathophysiology #pharmacology ... #potassium #medications
Hyperkalemia Treatment Options
Stabilize cardiac membrane:
 • IV Calcium (peaks 5-10 minutes)
Decrease potassium concentration:
 • IV Fluids
Shift
Hyperkalemia Treatment ... • IV Fluids Shift ... peaks 1-2h) • Blood ... LouLectures #Hyperkalemia ... #management #potassium
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 ... #potassium #high
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
Hyperkalemia - Differential ... Crush injury • Blood ... Intracellular Shift ... Blood transfusion ... #differential #
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
Hyperkalemia - Differential ... Crush injury • Blood ... Intracellular Shift ... Blood transfusion ... #differential #
Causes of Hyperkalemia
Pseudohyperkalemia
 - Tourniquet use
 - Hemolysis (in vitro)
 - Leukocytosis
 - Thrombocytosis
Intra- to extracellular
Causes of Hyperkalemia ... shift - Acidosis ... intoxication - Hyperkalemic ... Transfusion of aged blood ... Causes #diagnosis #differential