What medicine should be taken for hypokalemia?

Written by Wei Shi Liang
Intensive Care Unit
Updated on September 29, 2024
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The treatment of hypokalemia primarily involves addressing the underlying disease. Symptomatic treatment should avoid excessive potassium supplementation, which can lead to hyperkalemia. The principle of potassium supplementation is as follows: for mild hypokalemia, such as in patients showing clinical signs, oral potassium can be administered at 40-80 millimoles per day. For patients with severe hypokalemia, or those whose gastrointestinal tract cannot utilize potassium, with potassium levels less than 2.0 millimoles per liter, intravenous potassium can be provided. An initial supplementation rate of 10-20 millimoles per hour is relatively safe. In cases of severe hypokalemia with life-threatening clinical signs, a rapid increase to 40-80 millimoles can be achieved in a short period, but close monitoring is necessary.

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Written by Wang Li Bing
Intensive Care Medicine Department
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How to supplement potassium for hypokalemia

Hypokalemia generally has two common methods of potassium supplementation. The first is oral potassium supplementation, and the second is intravenous potassium supplementation. Oral potassium supplementation is the safest method, for example, taking potassium chloride sustained-release tablets orally, as well as potassium chloride injection solution orally, and eating more potassium-rich vegetables and fruits. The second method is intravenous potassium supplementation. For intravenous potassium supplementation, it is important to pay attention to the patient's urine output. If the patient's urine output is adequate, intravenous potassium supplementation can be appropriately performed, and the concentration of intravenous potassium supplementation should not exceed 0.3% to prevent arrhythmias caused by hyperkalemia. (Please use medications under the guidance of a doctor.)

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Written by Gan Jun
Endocrinology
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What are the symptoms of hypokalemia?

When the body's blood potassium level falls below 3.5 millimoles per liter, it is called hypokalemia. Hypokalemia can cause adverse symptoms in multiple systems of the body, initially causing weakness and fatigue in the limbs, flaccid paralysis, sluggish and absent tendon reflexes, and in severe cases, respiratory difficulty. At the same time, hypokalemia can lead to a series of central nervous system damages, such as apathy, a blank stare, drowsiness, and confusion; it also causes nausea, poor appetite, abdominal distension, and intestinal paralysis among other adverse gastrointestinal phenomena. Additionally, it can lead to palpitations, and rapid atrial or ventricular arrhythmias, among other adverse phenomena. Therefore, it is crucial to provide timely and proper potassium supplementation and correction of blood potassium levels for patients with hypokalemia.

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Written by Wei Shi Liang
Intensive Care Unit
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When supplementing potassium for hypokalemia, what should be paid attention to?

When supplementing potassium for hypokalemia, the following should be noted: 1. Closely monitor the blood potassium levels. Supplement 60-80 mmol/L of potassium, or recheck the blood potassium level within 1-4 hours after supplementation. 2. If the rate of potassium supplementation exceeds 10 moles per hour, continuous ECG monitoring should be maintained, closely observe the changes in the ECG, and prevent the occurrence of life-threatening hyperkalemia. 3. The rate of potassium supplementation for patients with regenerative dysfunction should be 50% of that for patients with normal kidney function. 4. The daily amount of potassium supplementation should not exceed 100-200 millimoles. 5. Try not to use peripheral veins for high-concentration potassium supplementation. 6. Use sodium chloride solution to dilute potassium-containing solutions, and it is not recommended to use glucose or low molecular weight dextrorotatory sugar as the carrier.

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Written by Wei Shi Liang
Intensive Care Unit
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Why does hypokalemia cause alkalosis?

Hypokalemia can cause metabolic alkalosis because it leads to the intracellular movement of hydrogen ions. In hypokalemia, potassium shifts from the inside to the outside of the cell to compensate for the decreased serum potassium. As an exchange, hydrogen ions from the gastric fluid move into the cells, causing cellular alkalosis and intracellular acidosis. Additionally, due to potassium deficiency in the renal tubular epithelial cells, the potassium-sodium exchange decreases and the sodium-hydrogen exchange increases, leading to enhanced excretion of hydrogen ions and increased reabsorption of bicarbonate ions, resulting in hypokalemia-induced metabolic alkalosis, which needs to be promptly addressed clinically.

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Written by Wei Shi Liang
Intensive Care Unit
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Causes of Hypokalemia

Common causes of hypokalemia include insufficient intake or prolonged inability to eat without intravenous supplementation. In such cases, while intake of potassium decreases, the kidneys continue to excrete potassium, leading to a loss of potassium in the blood. Additionally, increased excretion can cause hypokalemia, including losses from the gastrointestinal tract such as vomiting, diarrhea, and continuous gastrointestinal decompression, which results in a loss of digestive fluids rich in potassium. Potassium loss through the kidneys from prolonged use of potassium-wasting diuretics or during the polyuric phase of acute renal failure can also lead to hypokalemia. Furthermore, the shift of potassium from outside to inside the cells can cause hypokalemia.