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Potassium (Hyperkalaemia and Hypokalaemia) - Armando Hasudungan
Potassium (Hyperkalaemia and Hypokalaemia) - Armando Hasudungan
Potassium (Hyperkalaemia and Hypokalaemia) - Armando Hasudungan
Armando Hasudungan
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Overview Potassium (K+) is an important ion in the body. K+ is found mainly intracellularly (inside the cells)
whereas sodium (Na+) is found extracellularly (outside the cells). Therefore:
Therefore:
Hyperkalaemia: >5mmol/L
Hypokalaemia: <3.5mmol/L
As the pH rises , K+ is shifted intracellularly and the serum levels falls; conversely when serum pH
decreases, intracellular K+ shits extracellularly into the vascular space and so the serum level increases.
This is because H+ and K+ are both positive and it is important to have normal +ions levels in the serum to
maintain a gradient across the cell membrane to maintain the excitability of nerve and muscle cells,
including the myocardium.
Causes of Hyperkalaemia
Excessive intake
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↓↑Potassium (Hyperkalaemia and Hypokalaemia) | Armando Hasudungan 11/06/19, 11(07 AM
Increased production
Haemolysis
Rhabdomyolysis
Intense physical activity
Burns
Tumour lysis syndrome
Acidosis
Insulin deficiency/resistance
Medications
β-blocker
Suxamethonium
Digoxin
Spironolactone
Decreased excretion
Renal failure
Addison’s disease
Medications
Non-specific
Generalised muscle weakness
Respiratory depression
Ascending paralysis
Palpitations, Arrhythmia, Cardiac arrest
ECG CHANGES:
Management – nonpharmacological
ECG
Assess
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↓↑Potassium (Hyperkalaemia and Hypokalaemia) | Armando Hasudungan 11/06/19, 11(07 AM
Management – pharmacological
Insulin + Glucose
Salbutamol
Sodium bicarbonate – if acidotic
Pharmacology Calcium Resonium is a large insoluble molecule that binds to K+ in the large intestine,
where it is excreted in faeces. Side effects:
MANAGEMENT OF HYPERKALAEMIA
Salbutamol Salbutamol
Complications of Hyperkalaemia
Cardiac arrest
Weakness
Paraesthesiae
Decreased reflexes
Ascending paralysis
Hypokalaemia
Treatment
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↓↑Potassium (Hyperkalaemia and Hypokalaemia) | Armando Hasudungan 11/06/19, 11(07 AM
ECG findings
Peaked P waves
T wave flattening and inversion
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