Hyperkalemia

C-BIG-K-Drop Hyperkalemia
Step 1 : Hyperkalemia
Step 2 : Criteria
+
- K
- ECG Hyperkalemia, ECG
Hyperkalemia (life-threatening hyperkalemia)
heperkalemia ECG
- Renal Insufficiency
- Metabolic Acidosis
+
Criteria K < 6.0 mEq/L Step 4 (
)
Step 3 : Hyperkalemia C-BIG-K-Drop
calcium-bicarb-insulin-glucose-kayexalate-diuretics, dialysis

( Nasr Anaizi, PhD Rochester Institute of Technology, Drug Therapy in Kidney Disease, 2007
(http://www.thedrugmonitor.com/RIT2007oo.pdf)

1-3 10% calcium gluconate 10 ml IV push

K+ 10% calcium gluconate monitor EKG
10% calcium gluconate
-

 10-30 potassium
50% glucose 40-50 ml+ regular insulin (RI) 5-10 unit IV push
Capillary blood glucose
-

K+
Cation exchange resin kayexalate kalimate 30-60 g
30 2 kayexalate
sorbitol
hyperkalemia
(dialysis)
-

Step 4 : K

SPS (Kayexalate ) ()
Furosemide
hemodialysis
+

++

Ca
Gluconate
inj.
(10 ml of 10%)

10 ml 2-5
dose
5

30

NaHCO3
mEq/mL)

(1

50 mEq 5
dose
ECG

30-60

0.5-3

Insulin Glucose

10 Units RI + 50 ml D50W
(25g glucose=50 %glucose
50
ml=1
amp

30-60

3-4

Albuterol
Salbutamol
agonist)

(-

1.Sodium
Polystyrene
Sulfonate(SPS)

(Kayexalate )
2. Kalimate

0.5 mg iv 15
NB 10-20 mg 15

<30

1.15g (60 ml) PO 30-45

g rectally q6h)

2-3

2. 15g (60 ml) PO

2-6

Bicarb
++
Ca
Ceftriaxone
: Ca

Digoxin Toxicity
infuse (
20-30
) (
Mg Ca

Digoxin
Toxicity)

acidosis

load Na

tetany

seizures

bicarbonate

Correct
hypocalcemia
Glucose
glucose

<250 mg/dL

D5/HNS*
infusion
insulin
Tachycardia
tremor ()

Na

(Kayexalate)

Kalimate

 30

2%Methylcellulose
5%Glucose solution 100
. 3060

:
1 (5 ) 2-3
(3050 .) (

)
20-40 mg iv 5
(
)
-

Furosemide

Dialysis

30

Ceftriaxone Ca salts ( )
Ca soft tissues
: sorbitol bowel necrosis ( )
CHF ; Furosemide Na
Load
D5HNS = 5% dextrose in half normal saline ( 5%DN/2)

Kayexalate Kalimate
Kayexalate sodium resin Kalimate calcium resin
Kalimate
1
mEq 1 ()
2. Kalimate Kayexalate
1.

Kalimate Kayexalate Hyperkalemia

Kalimate
15-30 2-3
4. Kalimate ( )
Sorbitol ** Kalimate Kayexalate
3.

** sorbitol
colonic necrosis Kayexalate sorbitol

Kalimate

: ( Kayexalate)

1. : Dose Kayexalate 2-3 .

2. : 30 2%Methylcellulose 5%Glucose
solution 100 . 30-60
:
1 (5 ) 2-3 (30-50 .)
()


(1 (5 ) 30-50 .)

24 . () contaminate

Reference
-

Nasr Anaizi, PhD Rochester Institute of Technology, Drug Therapy in

Kidney Disease, 2007 (http://www.thedrugmonitor.com/RIT2007oo.pdf)
http://drug.pharmacy.psu.ac.th/Question.asp?ID=5299&gid=1

http://www.si.mahidol.ac.th/km/cops/medication_safety/admin/knowledge_fil
es/705_0.pdf
www.pharmyaring.com

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