See also:
Ddx
Medication side-effect
Nonselective beta-blockers | Interferes with beta-2-mediated intracellular potassium uptake
ACE-I, ARB, K+ sparing diuretics, Trimethoprim | Inhibition of aldosterone or ENaC channel
Digitalis | Inhibition of the Na-K-ATPase pump
Cyclosporine | Blocks aldosterone activity
Heparin | Blocks aldosterone production
NSAIDS | Decreases renal perfusion resulting in decreased K+ delivery to the collecting ducts
Succinylcholine | Causes extracellular leakage of potassium through acetylcholine receptors
Excessive dietary intake
Excessive intravenous intake (minimal but significant increases in potassium intake can cause elevations)
Acute or chronic renal failure (potassium excretion is diminished — the most common cause of hyperkalemia)
Tumor lysis syndrome
Addison's disease
Hypoaldosteronism
Aldosterone-inhibiting diuretics (e.g. spironolactone, triamterene)
Crush injuries to tissues
Hemolysis
Transfusion of hemolyzed blood
Infection (high cellular potassium is released by cell injury and lysis)
Acidosis (to maintain electrical neutrality, potassium is expelled from cells taking up hydrogen ions)
Dehydration (potassium is concentrated in dehydration and reduced with rehydration)
Emergent Tx (pts with EKG changes (unstable dysrhythmia) or hypotension)
Stabilize cardiac membranes
Immediate IV Calcium chloride
Calcium gluconate to stabilize cardiac membranes
It works quickly and is relatively safe unless patients are digitalized.
Shift potassium intracellularly
Insulin plus glucose
Sodium bicarbonate
Beta-2-agonists (e.g. Albuterol)
Sx
Muscle weakness
Flaccid paralysis
EKG changes
Sx (severe hyperkalemia)
Asystole
