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Definition
1) Decreased Aldosterone (ACE Inhibitors)
2) Kidney Failure (and NSAIDS-due to decreased renal blood flow)
3)Shift out of the cell
* tissue injury
* hemolytic
* tumors
* drugs (beta blockers, succinylcholine)
4)Other drugs: K- sparing diuretics
5)Acidosis |
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Term
| What does aldosterone normally do within the kidney? |
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Definition
| Causes sodium reabsorption and potassium excretion |
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Term
| Why does a decrease in aldosterone result in hyperkalemia? |
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Definition
| Because aldosterone causes Na reabsorption and K excretion, so if there is a deficient amount of aldosterone, the body will fail to excrete as much K and fail to reabsorb as much Na as normal. |
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| Why do ACE inhibitors cause hyperkalemia? |
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Definition
| -by blocking the Renin-Angiotensin-Aldosterone System (thereby decreasing aldosterone production |
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| What is the mechanism by which NSAIDs can cause hyperkalemia?` |
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Definition
-by blocking the conversion of arachadonic acid to prostaglandin
-some prostaglandins play a role in renal blood flow
-so RBF is reduced, if prostaglandins are blocked |
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Term
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Definition
Most symptoms are associated with disruption in resting membrane potentials
* Muscle Weakness (muscle frequently in a depolarized state)
* Arrhythmia progression |
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Term
| Arrhythmia Progression in Hyperkalemia |
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Definition
(mnemonic)Portly wombats play lacrosse so violently, awesome!
* Peaked T wave
* Widening QRS
* Prolonged PR
* Loss of P wave
* sine wave (no p wave, loss of R wave amplitude)
* V. Fib
* Asystole |
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| Treatments for hyperkalemia (7) |
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Definition
1)Give Calcium (if arrhythmias are present
2)Sodium Bicarbonate
3)Insulin
4)Hyperventilation
5)Beta 2 adrenergic agonists
6)Diuretics
7)Potassium exchange resins (kaexalate) |
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| What is the treatment for hyperkalemia if arrhythmias are present? |
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Definition
| IV Calcium, to raise the depolarization threshold |
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| If you had the choice to give calcium gluconate or calcium chloride to treat high K+ in a pt having arrhythmias, which would you choose and why? |
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Definition
| Calcium Chloride, because it will raise your ionized calcium more than calcium gluconate |
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| Which is the fastest treatment to lower potassium? |
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Definition
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| Sodium Bicarb Mechanism of Action |
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Definition
* HCO3- is added to the blood creating alkalosis
* So H+ ions leave the cell to decrease the pH
* b/c the H+ ions leave the cell, then K+ ions enter the cell |
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Term
| Insulin dose for hyperkalemia |
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Definition
* 10u regular insulin and 30-50G dextrose also)
* 30-60 minutes |
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Definition
* works by increasing the activity of the Na-K ATPase pump
* this results in movement of Na out of the cell and K into the cell |
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| For every ___mmHg decrease in PaCO2, serum K+ decreases ____mEq/L |
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Definition
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| Hyperventilation (how does it work to treat hyperkalemia)? |
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Definition
* Works by causing respiratory alkalosis
* So, H+ ions leave the cell to buffer and decrease the pH
* When the H+ ions leave the cell, K+ ions enter the cell, thus reducing K+ in the blood |
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Term
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Definition
| Work by increasing Na-K ATPase pump activity |
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