When should hyperkalemia be treated?
It is usually from levels above 6.5 mEq/L. Above 7.5 mEq/L treatment should be more aggressive.
¿Qué fármacos usamos para tratarla?
| Drug | Dose | Mechanism of action | Comments |
| Calcium gluconate 10% | 0.5 – 1.5 ml/kg slow IV with ECG | It reduces cardiac excitability by restoring the gradient between resting potential and threshold. | It does not lower levels but provides cardoprotection. |
| Dextrose 50% | 0.5 – 1.-5 ml/kg slow IV | Promotes entry into the cell by activation of the Na-KATPase pump | Subsequently supplement serum with 2.5 – 5% glucose. |
| Insulin and dextrose 50%. | 0.2 – 0.5 U/kg of rapid insulin and 2-4 4ml of 50% glucose per unit of insulin | Promotes entry into the cell by activation of the Na-KATPase pump | Subsequently supplement serum with 2.5 – 5% glucose. |
| Sodium bicarbonate | 1-2 mEq/kg IV slow 15 min | Increases extracellular pH and favours entry into the cell in exchange for hydrogen | |
| Terbutaline | 0.01 mg/kg slow IV | Promotes entry into the cell by activation of the Na-KATPase pump |
How often are values monitored once treatment is started?
Your values should be monitored hourly until they are established in the < 6.5 mEq/L range and remain stable there.
