Skip to 0 minutes and 15 secondsHyperkalemia Hyperkalemia is also very important. And we all know that in acute situation hyperkalemia is an ICU indication but for this group of chronic renal disease patient on their progressive hyperkalemia may be very graduate So we don't need to treat very aggressively Most of time those hyperkalemia in chronic renal disease patients may actually from some, in some medication like they used for blood pressure control including potassium-sparing, diuretics, and the ACE inhibitors.

Skip to 1 minute and 2 secondsSo that's very important for pharmacists to always look at those patients kidney function and decide whether or not so we need to advise a physician to discontinue the prescription of ACE inhibitor orthe potassium-sparing diuretics takes The patient with hyperkalemia usually have some very serious symptoms including muscle weakness and arrhythmia. And the treatment we know hyperkalemia normal level is around three point five to five. And so less than five is normal And in this group for chronic disease patient, if the patient has mild hyperkalemia without EKG changed, we may only go through dietary control. Below patient, we has a severe kalemia.

Skip to 2 minutes and 6 secondsNow we will actually go through a similar treatment as those acute curves of hyperkalemia using those calcium gluconate or other medications. And if above a seven now required ICU treatment. So trimethyl hyperkalemia including a few parts The first part as to restore no more heart conduction. So piquillos actually potassium is actually competing with calcium in our heart. So that's a very serial problem of arrhythmia. And thus causing Gluconate will be important for this group of a patient to protect their heart function. So that usually requires IV infusion. And the other strategy we can use using insulin and glucose to shift potassium back to those selves.

Skip to 3 minutes and 19 secondsSo in this way is actually also temporary treatment but onset will be very quickly and we will see potassium level decrease quickly. And there are other motto to shift potassium back to intracellular including us bicarbonate or beta agonist but these two muscles are actually not often applied in clinical. And the last slide is actually using sulfonate to those resin to binding our excessive of potassium to truly excrete potassium from the body. So consulate is a very important Kalimate as a commonly used in our patient in chronic renal disease and thus those oral dosing and regular taking a kalimate is common .

Skip to 4 minutes and 28 secondsbut we also still need to monitor if the patient's potassium level is back to normal and if the patient's back to normal we probably still can consider to discontinue those medications. And the other issue is about carefully educated patient about those high potassium diet, those patient may not want to use those substitute of salt. Because those substitute of salt is actually highly kalemia contents.

Fluid and Electrolytes imbalance : Hyperkalemia

In this step, Prof. Chen explains the causes, the signs and symptoms, and the treatment of hyperkalemia.

To begin with, the causes of hyperkalemia may include excessive load, metabolic acidosis, and some medication, such as ACE inhibitors.

Following that, the signs and symptoms of hyperkalemia include muscle weakness, confusion, and arrhythmia.

As we know, the normal serum kale level is around 3.5 to 5, and we need different treatments to apply to different serum levels.

Actually, potassium is competing with calcium in our heart. Therefore, calcium gluconate will be important for patients to restore normal heart conduction and to protect their heart function. Another strategy is using insulin and glucose to shift potassium back.

Finally, sulfonate can be used for binding our excessive potassium in order to excrete potassium from our body. Kalimate is also commonly used in patients with chronic renal disease.

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This video is from the free online course:

Pharmacokinetics: Drug Dosing in Renal Disease

Taipei Medical University