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Essential Ions
Essential Ions
Essential Ions
Faculty of Pharmacy
Lecture 2
Essential ions
Lec. Ph.D Aamer Mousa Ali
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Potassium
• Potassium has atomic number 19 and the chemical symbol K, which is derived
from its Latin name ‘kalium’.
Biological importance:
• Potassium ions are essential for the human body and are also present in plants,
• The so-called action potential occurs in a variety of excitable cells such as
neurons, muscle cells and endocrine cells
• The Na+/K+-based action potential is short-lived (only 1 ms) and therefore
mostly found in the brain and nerve cells
• In the human body, 95% of the K+ can be found inside the cells, with the
remaining 5% mainly circulating in the blood plasma
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• This balance is carefully maintained by the Na+/K+ pump, and imbalances, such as
seen in hypo or hyperkalaemia, can have serious consequences.
Hypokalemia. is a potentially serious condition where the patient has low levels of K+ in
his/her blood Plasma
Symptoms
• include weakness of the muscles or ECG (electrocardiogram) abnormalities
hypokalemia can be a result of
• reduced K+ intake caused by GI disturbance , such as diarrhea and vomiting
• increased excretion of K+ caused by diuresis is often found in patients treated with
diuretics such as thiazides
• Potassium ions are excreted via the kidneys. Within the kidneys, ∼150–180 of plasma
is filtered every day through the glomerulus, which is part of the nephron
• a variety of ions are secreted and re-absorbed in order to regulate plasma imbalances
and manage the urine volume
• K+ is passively secreted at the proximal tubule and also moves into the interstitial fluid
via a counter-flow process to Na+ mainly at the distal tubule (Figure 2.1).
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Figure 2.1: Illustration of a nephron showing areas of potassium transport
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Oral supplementation
Oral supplementation in form of potassium salts is especially necessary in
patients
• patients who is take anti-arrhythmic drugs
• patients who is suffer from renal artery stenosis.
• patients who is suffer from severe heart failure.
• patients who is shown severe K+ losses due to
chronic diarrhea
abusive use of laxatives
• Regulation of the plasma K+ level may also be required in the care of
elderly patients when the K+ intake is reduced as a result of changing
dietary habits (special attention has to be given to patients with renal
insufficiency because K+ excretion might be reduced)
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Potassium salts and their clinical application:
•Potassium salts are preferably given as liquid preparations, and KCl is the preferred salt
used.
•Other potassium-based salts can be used if the patient is at risk of developing
hyperchloraemia – increased chloride plasma levels
•Typically potassium salts are dissolved in water, but the salty and bitter taste makes
them difficult to formulate
•Oral bicarbonate solutions such as potassium bicarbonate are typically given orally for
chronic acidosis states – low pH of the blood plasma
This can be again due to impaired kidney function. The use of potassium bicarbonate
for the treatment of acidosis has to be carefully evaluated
Potassium citrate is used in the United Kingdom as an over-the-counter drug for the
relief from discomfort experienced in mild urinary-tract infections by increasing the
urinary pH(It should be not given to men if they experience pain in the kidney area (risk
of kidney stones) or if blood or pus is present in the urine. Also, should avoid taking
potassium citrate without consultation with their general practitioner (GP). Caution is
generally advised to patients with renal impairment, cardiac problems and the elderly
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Adverse effects and toxicity: hyperkalaemia
• The therapeutic window for K+ in the blood plasma is very small (3.5–5.0 mmol), and
especially hyperkalemia, an increased level of K+ in the plasma, can lead to severe health
problems
• Potassium salts can cause nausea and vomiting and in extreme cases can lead to small
bowel ulcerations
• Acute severe hyperkalaemia is defined when the plasma potassium concentration
exceeds 6.5 mmol/l or if ECG changes are seen
• This can lead to cardiac arrest, which needs immediate treatment
Treatment options include
the use of calcium gluconate intravenous injections, which minimises the effects of
hyperkalaemia on the heart
The intravenous injection of soluble insulin promotes the shift of potassium ions into the
cells
Diuretics can also be used to increase the secretion of K+ in the kidneys
and dialysis can be a good option if urgent treatment is required
• Potassium salts are also available in the form of tablets or capsules for oral application
especially as nonprescription
• very high concentrations of K+ are known to be toxic to tissue cells and can cause injury to
the gastric mucosa. Therefore, nonprescription potassium supplement pills are usually
restricted to < 100 mg K+
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Magnesium
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Biological importance:
• Mg2+ is an essential ion in the human body
Mg2+ is a crucial constituent in numerous enzymatic processes
Mg2+ is essential to most living cells as a signaling molecule and is involved in nucleic
acid biochemistry dealing with the manipulation of ATP (adenosine triphosphate), DNA,
RNA and related processes. For example, ATP has to be coordinated to a magnesium ion
in order to become biologically active. Mg2+ also stabilizes DNA and RNA structures,
which can be seen in their increased melting points.
• Mg2+ ions form the redox-active center in chlorophyll
• In the human body, Mg2+ is the fourth most abundant cation and the second most
abundant ion in the interstitial fluid
• Mg2+ is an essential co-factor dealing with more than 300 cellular enzymatic processes
Clinical features
the human body contains about 24 g of magnesium ions, with half of it being incorporated
into bones and the other half being present in muscles and soft tissue
• The majority of Mg2+ is absorbed in the ilium and colon, and the kidneys are the major
excretory organ
• Mg2+ is filtered at the glomerulus
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• The kidneys regulate the magnesium ion levels in plasma.
• Magnesium ion imbalances can manifest in a variety of conditions such
as hypo- and hypermagnesaemia.
• Hypermagnesia
as a result high levels of Mg2+ are retained when the patient has renal
failure
hypermagnesia can cause muscle weakness and arrhythmia, but it is a
rare condition
• Hypomagnesia
defined as low magnesium levels in the blood plasma,
can be the result of losses in the GI tract, for example, excessive
diarrhea , alcoholism
Hypomagnesia is often followed by hypocalcaemia (low calcium ion
plasma levels) as well as hypokalaemia and hyponatraemia
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Oral supplementation and preparations
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Thank you
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