Note: electrolyte disturbances often occur together, check others (Ca^2+, Mg^2+, PO4^2-)

Medications Associated with Hypokalemia

Adapted from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357351/

Class	Examples	Mechanism
Antimicrobials	Nafcillin Ampicillin Aminoglycosides Amphotericin B Foscarnet	Renal potassium loss
Beta2-receptor agonists	Albuterol Formoterol, Salmeterol Ephedrine Epinephrine, Pseudoepedrine Isoproterenol Terbutaline	K+ shift from extracellular to intracellular
Diuretics	Acetazolamide Bumetanide Chlorthalidone Furosemide Indapamide Metolazone Thiazides Torsemide	Renal potassium loss
Insulin	High dose (overdose)	K+ shift from extracellular to intracellular
Mineralocorticoids and glucocorticoids	Hydrocortisone, fludrocortisone, prednisone	Renal potassium loss
Laxatives	Sodium polystyrene sulfonate Phenolphthalein Sorbitol	Stool (GI) potassium loss
Xanthines	Theophylline Caffeine	K+ shift from extracellular to intracellular
Other	Verapamil (overdose)	K+ shift from extracellular to intracellular

 

Replacement

Potassium replacement, acute, first line
     40 mEq KCl elixir

Potassium replacement, subacute
     KCl 1500 mg po daily

Potassium replacement, acute, IV or second line
     10 mEq KCl in 100 mL NS over 1 hour x 3
           repeat LBC in 4-12 hours

Potassium replacement, outpatient
      Micro K 8 mg PO 2 tabs daily x 3 days

Content on this page has not been checked for accuracy. The author's credentials have not been confirmed. Always use multiple peer-reviewed scholarly sources and good clinical judgement in your decision making.

The Compendium platform was created by David Kwinter, MD, CCFP(EM).