36 HYPERKALEMIA General Discussion Hyperkalemia is defined as a serum potassium concentration greater than 5.0 mEq/L and can become life threatening when the potassium concentration rises above 6.5 mEq/L. Hyperkalemia often is asymptomatic, but may affect normal cardiac conduction, producing characteristic EKG changes which are outlined below. Although there is no clear correlation between the degree of hyperkalemia and the likelihood of life-threatening arrhythmias, an arrhythmia is more likely to occur if the serum potassium concentration increases rapidly. All patients with a serum potassium concentration greater than 6.0 mEq/L should be considered at risk for cardiac arrhythmias. All disorders of potassium occur because of abnormal handling of potassium in one of three ways: problems with potassium intake, problems with potassium excretion, or problems with distribution of potassium between the intracellular and extracellular spaces. The primary source of potassium intake is through food. Generally speaking, fruits and vegetables have the highest concentrations of potassium. Salt substitutes represent a commonly overlooked source of dietary potassium. Under normal circumstances, 80–90% of dietary potassium is eliminated via renal excretion. The organ systems affected by hyperkalemia are cardiac, neuromuscular, and gastrointestinal. Symptoms may include not feeling well, fatigue, paresthesias, muscle weakness, or muscle cramps. Over 80% of clinical episodes of hyperkalemia are caused by impaired potassium excretion caused by renal insufficiency. Patients with acute renal failure are at greater risk for life-threatening complications from hyperkalemia because the potassium level rises more rapidly. Medications and Supplements Associated with Hyperkalemia Alpha blockers Amino acids • Arginine • Epsilon-aminocaproic acid • Lysine Angiotensin converting enzyme (ACE) inhibitors Angiotensin receptor blockers Azole antifungals Beta blockers Cyclosporine Digoxin Eplerenone Ethinyl estradiol/drospirenone Herbal remedies and nutritional supplements • Alfalfa • Dandelion • Hawthorn berries • Horsetail • Lily of the valley • Milkweed • Nettle • Noni juice • Siberian ginseng Heparin Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: ARTHRITIS AND ARTHRALGIA HAIR LOSS INFERTILITY, MALE SYNCOPE Stay updated, free articles. Join our Telegram channel Join Tags: Instant Work-ups A Clinical Guide to Medicine Aug 17, 2016 | Posted by admin in PEDIATRICS | Comments Off on HYPERKALEMIA Full access? Get Clinical Tree
36 HYPERKALEMIA General Discussion Hyperkalemia is defined as a serum potassium concentration greater than 5.0 mEq/L and can become life threatening when the potassium concentration rises above 6.5 mEq/L. Hyperkalemia often is asymptomatic, but may affect normal cardiac conduction, producing characteristic EKG changes which are outlined below. Although there is no clear correlation between the degree of hyperkalemia and the likelihood of life-threatening arrhythmias, an arrhythmia is more likely to occur if the serum potassium concentration increases rapidly. All patients with a serum potassium concentration greater than 6.0 mEq/L should be considered at risk for cardiac arrhythmias. All disorders of potassium occur because of abnormal handling of potassium in one of three ways: problems with potassium intake, problems with potassium excretion, or problems with distribution of potassium between the intracellular and extracellular spaces. The primary source of potassium intake is through food. Generally speaking, fruits and vegetables have the highest concentrations of potassium. Salt substitutes represent a commonly overlooked source of dietary potassium. Under normal circumstances, 80–90% of dietary potassium is eliminated via renal excretion. The organ systems affected by hyperkalemia are cardiac, neuromuscular, and gastrointestinal. Symptoms may include not feeling well, fatigue, paresthesias, muscle weakness, or muscle cramps. Over 80% of clinical episodes of hyperkalemia are caused by impaired potassium excretion caused by renal insufficiency. Patients with acute renal failure are at greater risk for life-threatening complications from hyperkalemia because the potassium level rises more rapidly. Medications and Supplements Associated with Hyperkalemia Alpha blockers Amino acids • Arginine • Epsilon-aminocaproic acid • Lysine Angiotensin converting enzyme (ACE) inhibitors Angiotensin receptor blockers Azole antifungals Beta blockers Cyclosporine Digoxin Eplerenone Ethinyl estradiol/drospirenone Herbal remedies and nutritional supplements • Alfalfa • Dandelion • Hawthorn berries • Horsetail • Lily of the valley • Milkweed • Nettle • Noni juice • Siberian ginseng Heparin Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: ARTHRITIS AND ARTHRALGIA HAIR LOSS INFERTILITY, MALE SYNCOPE Stay updated, free articles. Join our Telegram channel Join Tags: Instant Work-ups A Clinical Guide to Medicine Aug 17, 2016 | Posted by admin in PEDIATRICS | Comments Off on HYPERKALEMIA Full access? Get Clinical Tree
