Hypokalemia

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Background

Clinical Features

Differential Diagnosis

Differential diagnosis of hypokalemia

Intracellular Shift

  • Alkalosis (each 0.10 rise in pH causes 0.5 decrease)
  • Insulin
  • B-agonist

Decreased intake

  • Special diets or those low in potassium
  • Chronic alcohol abuse

Increased loss

Drugs

Evaluation

ECG Hypokalemia.jpg

Management

  • Potassium repletion (PO or IV)
    • Every 10mEq KCl → serum K ↑ ~0.1mEq/L
    • PO preferred (if symptomatic or level is <2.5, both oral and IV should be given)
  • Oral potassium
    • Inexpensive and rapidly absorbed
    • KCl tablet (elixir form available but has poor taste)
    • K-Dur (extended release tablet) is large and may be difficult to swallow
  • Intravenous potassium
    • Must be given in dilute solutions at slow rate (10meq/hour) to minimize side effects and cardiac toxicity
    • Generally should not give more than 40mEq via IV
    • Side effects: Local tissue burning, phelbitis, sclerosis
  • Also treat Hypomagnesemia if present
  • Re-check ECG after treatment [1]

Disposition

  • Based on underlying cause

See Also

External Links

References

  1. Slovis, Corey. "Electrolyte Emergencies". Presentation.