#IntracellularFluid #ICF #MajorAnions #Phosphate #MajorCations #Potassium #Magnesium #pH7.0 #ExtracellularFluid #ECF #MajorAnions #Chloride

Intern Pocket Cards - Electrolyte Repletion Guide Electrolyte Repletion: - Potassium (ref range 3.5-4.5) - Magnesium (ref range 1.3-1.7) - Calcium (ref range 8-10) - Phosphate (ref range 2.5-4.5) Dr. Satya Patel @SatyaPatelMD Full Inpatient Pocket Cards Collection: https://bit.ly/pocketcardset #Electrolyte #Repletion #Guide #management #inpatient #internship #potassium #phosphate #phosphorus #magnesium

Phosphate Electrolyte Repletion Oral: Neutra-Phos, Neutra-Phos-K, K-Phos Neutral (Na and K Phos) Intravenous: Potassium Phosphate, Sodium Phosphate Satya Patel @SatyaPatelMD #Phosphate #Electrolyte #Repletion #hypophosphatemia #intern #phosphorus

Hyperkalemia Management Membrane Stabilizers: • Calcium gluconate Shifters: • Insulin + glucose • Albuterol Excreters: • Furosemide • Sodium bicarbonate • Sodium polystyrene sulfonate Definitive: • Hemodialysis UCSD Internal Medicine @ucsdim #Hyperkalemia #Management #Treatment #Potassium

Acute Hyperkalemia Management • Membrane Stabilization: Calcium Gluconate (10%), Hypertonic (3%) Normal Saline • Shifters: Insulin (Short Acting) Albuterol • Excreters: Furosemide, Sodium Bicarbonate, Sodium Polystyrene Sulfonate • Definitive: Hemodialysis #Acute #Hyperkalemia #Management #treatment #potassium

Pharmacologic Management of Constipation Commonly used laxatives: • Bulk-forming laxatives - Psyllium, methylcellulose, polycarbophil • Osmotic laxatives - Sodium phosphate, polyethylene glycol, sorbitol, lactulose, magnesium hydroxide, magnesium citrate, magnesium sulfate • Stimulants - Diphenylmethane derivatives (bisacodyl, sodium picosulfate), anthraquinones (sennoside, aloe, cascara) • Stool softeners - Docusate sodium, docusate calcium • Lubricants - Mineral oil Newer agents: • Chloride channel activators - Lubiprostone • Guanylate cyclase C receptor agonists - Linaclotide, plecanatide • Selective serotonin 5-HT4 receptor agonists - Prucalopride, cisapride, tegaserod • Ileal bile acid transporters inhibitors - Elobixibat #Constipation #Management #treatment #medications #pharmacology

Hyperkalemia Treatment Options Stabilize cardiac membrane: • IV Calcium (peaks 5-10 minutes) Decrease potassium concentration: • IV Fluids Shift potassium intracellularly: • Insulin + dextrose (peaks 30-60 minutes) • Albuterol (4-8x dose used for bronchodilation) (peaks 90 minutes) • Sodium bicarbonate Potassium excretion: • Urinary (if preserved renal function) - Loop diuretic (often with saline IVF) (peaks minutes) • Stool - Kayexylate +/- lactulose (peaks 1-2h) • Blood - Hemodialysis By Dr. Christian Matar @LouLectures #Hyperkalemia #management #potassium #nephrology

ECG Changes in Hyperkalemia and Treatment Membrane Stabilization - Calcium gluconate or chloride Redistribution - Insulin - Albuterol - Sodium bicarbonate Elimination - Furosemide - Sodium polystyrene - Hemodialysis #Hyperkalemia #Treatment #Management #Diagnosis #ECG #EKG

EKG CHANGES AS A RESULT OF CHANGES IN NA OR K CHANNEL CONDUCTION - GRAPHIC BY JAMES LI, MD #Pathophysiology #Toxicology #Cardiology #EKGChanges #ECG #Channelopathy #Channels #NaK #Sodium #Potassium

Potassium-Binding Agents to Treat Hyperkalemia Sodium zirconium cyclosilicate (Lokelma): • Mechanism: Preferentially captures K in exchange for hydrogen and sodium • Dosing: Initial: 10 g TID for up to 48 hours. Maintenance: 10 g QD (adjust dose at weekly intervals in 5-g increments to obtain the desired serum K range). Usual maintenance dose: 5 g QoD to 15 g QD • Side Effects: Edema (mild to moderate); hypokalemia Patiromer (Veltassa): • Mechanism: Exchanges calcium for K; also binds magnesium • Dosing: Initial: 8.4 g QD; increase dose as necessary at 1-wk intervals in increments of 8.4 g • Side Effects: Hypomagnesemia; hypokalemia; constipation, diarrhea, nausea, abdominal discomfort, flatulence Sodium polystyrene sulfonate (Kayexelate): • Mechanism: Sodium-K exchange resin/polymer; nonspecifically binds K, magnesium, and calcium • Dosing: 15 g (4 level teaspoons) 1-4 times daily • Side Effects: Intestinal necrosis; electrolyte disturbances (including hypokalemia); nausea, vomiting, constipation, diarrhea; fluid overload in patients sensitive to high sodium intake; risk of aspiration #Potassium #Binding #Hyperkalemia #medications #pharmacology #table #comparison #binders

Adrenal Insufficiency Expected Metabolic Abnormalities Textbook changes in chemistry panel due to adrenal insufficiency. Of course, "textbook" means "rarely seen in actual clinical practice." #Adrenal #Insufficiency #Metabolic #Abnormalities #Chemistry #Panel #Changes #Potassium #Sodium #Electrolytes #Addisons #BMP