rxspecialist

The treatment of hyperkalemia can be 4 fold: 1.) Calcium Gluconate or Calcium Chloride This is given to prevent cardiac arrhythmias that may be caused by the high serum potassium. This should be given first, and will be considered a cardio-protective measure. Calcium will not reduce the serum potassium levels, but will prevent potential arrhythmias. The following measures should also be given immediately after the Calcium is administered. 2.) Insulin Regular + D50W D50W alone will not do anything to lower the serum potassium level. The Dextrose is given to counteract the hypoglycemia caused by the insulin. Insulin Regular is given because it increases the permeability of many cells to potassium. Insulin activated sodium-potassium ATPase channels in many cells, which will cause a influx of potassium ions from the plasma into the cells. 3.) Kayexelate or Sodium polystyrene Kayexelate is given as a potassium binder, and it will bind to potassium to form potassium polysyrene sulfonate and will be excreted in the feces. 4.) Sodium bicarbonate Sodium bicarbonate will raise the pH level in the plasma to help facilitate the influx of potassium into the cells via the sodium-potassium ATPase channel.