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Skip to 0 minutes and 14 seconds And let’s look at other electrolytes imbalance As very common we see patient with hyperphosphatemia and hypocalcemia and hypermagnesemia and along with these three issues. We will see a patient has bad bone osteodystrophy So hyperphosphatemia has actually from renal reducer renal excretion and hypocalemia is also from those patients PTH level and hypermagnesia also require our discontinued with some magnesium continent untested and for calcium a phosphorus balance, we need to always remember keep calcium concentration and the phosphate level the summation less than fifty-five milligram per deciliter. For hyperphosphatemia we can actually use some calcium carbonate or acetate, citrate And most commonly used as calcium carbonate.

Skip to 1 minute and 39 seconds So that will actually has a lots of a productivist selected we need to care for to look at those products whether or not and those superior has something else other than calcium carbonate And there are the other few newer polymer binders for phosphate. What is sevelamer? And this is a very important new phosphate binder. There there are two different salts including carbonate salts and hydrochloride salts. Using these salts, you usually need to also consider about the dosing equivalence. So there is a formula for your reference. And using this new binder, there are some ADR occurred including fecal impaction ileus or some intestinal obstruction Let’s need to carefully watch out.

Skip to 2 minutes and 54 seconds And then follow me, There is another new phosphate binder and this usually need to think about those aluminum salts. And also reduce the bioavailability of ciprofloxacin and levothyroxine is very important drug in action.

Fluid and Electrolytes imbalance : Hyperphosphatemia & hypocalcemia

In this step, Prof. Chen explains hyperphosphatemia, hypocalcemia, hypermagnesemia, and calcium and phosphorus balance.

To begin with, hyperphosphatemia is from reduced renal excretion and excessive cellular release, and hypocalcemia is from an abnormal PTH level.

For calcium and phosphorus balance, we need to keep the product of calcium concentration and the phosphate level less than 55 milligrams per deciliter.

Besides, there are other polymer binders, including Sevelamer HCL and Sevelamer carbonate. However, they may cause some ADRs, such as fecal impaction and intestinal obstruction.

Following that, there is another new phosphate binder, called Lanthanum, which dissociates into a trivalent cation with similar binding. Lanthanum will reduce the bioavailability of ciprofloxacin and levothyroxine.

Have you ever used Lanthanum in clinical practice? Please share your experience before.

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This video is from the free online course:

Pharmacokinetics: Drug Dosing in Renal Disease

Taipei Medical University