![]() ![]() Relative medical contraindications were noted in 88% of the patients and drug contraindications were noted in 37% of the patients receiving Kayexalate. ![]() Absolute medical contraindications were noted in 6% of the patients sampled. Electrolyte disturbances pretreatment were noted to be as follows: hypocalcemia in 9% of the patients, hypomagnesemia in 0% of the patients, and hypernatremia in 9% of the patients. Forty-one females and 24 males from the medicine, surgery, and obstetrics and gynecology departments were reviewed in this study and analysis of the data revealed the following values: Kayexalate was administered without following proper indications (defined as moderate to severe hyperkalemia), with absolute contraindications, or with drug contraindications and no alternative modalities were employed in 46 (71%) of the patients. Data were collected and analyzed for the following outcomes: Kayexalate administered without following proper indication or when contraindicated, administration resulting in serum electrolyte abnormalities, and other adverse effects within 12 hours of administration. We hope to educate clinicians and house staff about the indications and methods of treatment of hyperkalemia so that they will develop a systematic approach and integrate all aspects of the hyperkalemic patient's history and current condition when selecting their treatment strategy.Ī randomized, retrospective chart review of 65 medical records from patients who received Kayexalate between November 2007 and November 2008 was conducted. This article focuses on the pathogenesis of hyperkalemia, its clinical manifestations, and various treatment modalities for acute hyperkalemia. These findings are probably not unique to our institution and thus support the need for a more systematic approach to the assessment and management of hyperkalemia. In 71% of patients, a cation exchange resin was administered, without appropriate indications, without alternative measures being employed, or when contraindicated. A retrospective chart review at our institution of patients treated with cation exchange resin demonstrated inconsistencies in the management of hyperkalemia. It should be treated in a timely manner employing all available resources. Severe hyperkalemia, a potentially life-threatening condition, can cause muscle paralysis and lethal cardiac arrhythmias. Prompt detection and proper treatment are crucial in preventing lethal outcomes. ![]() ![]() Hemodialysis remains the most reliable method to remove potassium from the body and should be used in cases refractory to medical treatment. Treatment should be started with calcium gluconate to stabilize cardiomyocyte membranes, followed by insulin injection, and b-agonists administration. Hyperkalemia with potassium level more than 6.5 mEq/L or EKG changes is a medical emergency and should be treated accordingly. Management of hyperkalemia includes the elimination of reversible causes (diet, medications), rapidly acting therapies that shift potassium into cells and block the cardiac membrane effects of hyperkalemia, and measures to facilitate removal of potassium from the body (saline diuresis, oral binding resins, and hemodialysis). Early recognition of moderate to severe hyperkalemia is vital in preventing fatal cardiac arrhythmias and muscle paralysis. Hyperkalemia, a life-threatening condition caused by extracellular potassium shift or decreased renal potassium excretion, usually presents with non-specific symptoms. This article focuses on the pathogenesis, clinical manifestations, and various treatment modalities for acute hyperkalemia and presents a systematic approach to selecting a treatment strategy. ![]()
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