Hypokalemia

Revision as of 20:40, 2 March 2012 by Jswartz (talk | contribs)

Background

  • Low = <3.5meq/L
  • Low! = <2.5meq/L

Clinical Features

  • CNS
    • Weakness
    • Cramps
    • Hyporeflexia
  • GI
    • Ileus
  • Renal
    • Met alkalosis
  • CV
    • PACs/PVCs
    • Bradycardia or atrial/junctional tachycardia
    • AV block
    • V tach, V fib

Diagnosis

  • ECG findings:
    • ST seg depression
    • U wave (V4-V6)

ECG Hypokalemia.jpg

DDX

  • Shift
    • Alkalosis (each 0.10 rise in pH causes 0.5 decrease)
    • Insulin
    • B-agonist
  • Decreased intake
  • Increased loss
    • GI (v/d/fistula)
    • Renal
      • Diuretics
      • Hyperaldo
    • Exercise
      • HyperCa
      • HypoMg
  • Drugs
    • PCN
    • Lithium
    • L-dopa
    • Theophyline

Treatment

  • 20meq/hr KCl IV or PO
    • every 10meq should inc serum by ~0.1meq/L
  • Treat hypomag if present

Source

  • Tintinalli
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