Hyperkalemia
Posted by dkwinter

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

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