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Old 01-14-2015
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Default Hyperkalemia Treament order confusion

Hey gang ... Can someone shed the light on the exact order of treatment. I am a little confused ... this is what I have ... Not sure if it is correct ...

1) Furosmide (No ECG) less than 6.5
2) > 6.5 (No ECG) Sodium polystyrene sulfonate
3) GT 6.5 with ECG changes - Sodium polystyrene sulfonate & Calcium Gluconate

When is this used??

Inhaled B2-Agonst to move Potassium into cells

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Old 01-14-2015
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Here's what I understand:

Hyperkalemia with ECG changes --> treatment is based on 3 steps:

1) step is Stablizing the heart (calcium gluconate (if any ECG changes). Calcium Gluconate is given to protect the heart and will not bring potassium down.

2) step is lowering potassium by shifting potassium intracellularly --> use either Insulin + Glucose or beta-2 agonists like albuterol. They do not remove potassium from the body (only redistributes into the cells)

3) step is removing potassium out of body --> use Sodium polystyrene sulfonate (Kayexalate). It takes several hours to work.
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