Hyperkalemia
- ECG changes/severe K → stabilize myocardium
- Shift K intracellularly
- insulin/glucose ± beta-2 agonist
- Remove K: diuresis, binder or dialysis
- Stop/reduce contributors when appropriate
- Rebound is common → repeat K measurements
- Treat the underlying renal/acidosis problem
Use at a glance
- ECG changes/severe K → stabilize myocardium
Treatment options
- Shift K intracellularly
- insulin/glucose ± beta-2 agonist
Practical pearls
- Remove K: diuresis, binder or dialysis
- Rebound is common → repeat K measurements
Choosing treatment
- Stop/reduce contributors when appropriate
- Treat the underlying renal/acidosis problem
Self-check
- What comes first with severe hyperkalemia plus ECG changes?
IV calcium to stabilize the myocardium.
- Why should potassium be rechecked after acute treatment?
Rebound is common.
Drugs used for this (4)
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