Brady WJ, �F�;��\�G����=Zϵ���J���s]w�8ޓ��)u:�"�̢hR����Uo=�m����c"������]�QnW��Z�v ��%2Z��7S&�p��CM|�� Torsemide is a loop diuretic (water pill) that is used to treat fluid retention in people with heart failure, liver disease, or kidney disease.. Torsemide is also used to treat high blood pressure (hypertension).
Gomes T, A consequence of magnesium deficiency. Furthermore, torsemide may be a better option to prevent thiazide-induced hypokalemia compared with a potassium-sparing diuretic such as triamterene … Gross P, Therapeutic approach to hypokalemia. Harrigan RA, Montoliu J, Emergency interventions for hyperkalaemia.
Campistol JM, If you log out, you will be required to enter your username and password the next time you visit. Hyperkalaemia in patients in hospital. )Calcium chloride, 10 mL of 10% solution IV over 5 to 10 minutes, or calcium gluconate, 30 mL of 10% solution IV over 5 to 10 minutesStabilizes cardiac muscle cell membrane; no effect on serum potassium or total body potassiumMay potentiate digoxin toxicity; calcium chloride can cause phlebitis and tissue necrosisRegular insulin, 10 units IV followed immediately by 50 mL of 50% glucose (25 g) IVShifts potassium into cells; no effect on total body potassiumMay cause hypoglycemia; glucose is unnecessary if serum glucose level is > 250 mg per dL (13.9 mmol per L); additive effect when combined with albuterolShifts potassium into cells; no effect on total body potassiumCan cause tachycardia and thus should be used with caution in patients with underlying heart disease; potassium-lowering effect not reliable in all patients; additive effect when combined with insulinRectal: 30 to 50 g every 6 hours in a retention enemaBinds potassium in exchange for sodium; lowers total body potassiumAssociation with gastrointestinal complications, particularly when combined with sorbitol; should be avoided in patients at risk of abnormal bowel functionCalcium chloride, 10 mL of 10% solution IV over 5 to 10 minutes, or calcium gluconate, 30 mL of 10% solution IV over 5 to 10 minutesStabilizes cardiac muscle cell membrane; no effect on serum potassium or total body potassiumMay potentiate digoxin toxicity; calcium chloride can cause phlebitis and tissue necrosisRegular insulin, 10 units IV followed immediately by 50 mL of 50% glucose (25 g) IVShifts potassium into cells; no effect on total body potassiumMay cause hypoglycemia; glucose is unnecessary if serum glucose level is > 250 mg per dL (13.9 mmol per L); additive effect when combined with albuterolShifts potassium into cells; no effect on total body potassiumCan cause tachycardia and thus should be used with caution in patients with underlying heart disease; potassium-lowering effect not reliable in all patients; additive effect when combined with insulinRectal: 30 to 50 g every 6 hours in a retention enemaBinds potassium in exchange for sodium; lowers total body potassiumAssociation with gastrointestinal complications, particularly when combined with sorbitol; should be avoided in patients at risk of abnormal bowel functionPotassium can be removed via the GI tract or the kidneys, or directly from the blood with dialysis. Shumaik GM, To see the full article, log in or purchase access.A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. The most accurate method for evaluating urinary potassium excretion is a 24-hour timed urine potassium collection; normal kidneys excrete no more than 15 to 30 mEq per L (15 to 30 mmol per L) of potassium per day in response to hypokalemia. Drug-induced hyperkalemia: old culprits and new offenders.
Rapid correction is possible with oral potassium; the fastest results are likely best achieved by combining oral (e.g., 20 to 40 mmol) and intravenous administration.When intravenous potassium is used, standard administration is 20 to 40 mmol of potassium in 1 L of normal saline. Therefore, a first priority is determining the need for urgent treatment through a combination of history, physical examination, laboratory, and electrocardiography findings. Guidi GC. Is hypomagnesemia arrhythmogenic? Schambelan M, Soar J, Ethier JH, Gennari FJ. Correction typically should not exceed 20 mmol per hour, although higher rates using central venous catheters have been successful in emergency situations.Nonurgent hypokalemia is treated with 40 to 100 mmol of oral potassium per day over days to weeks. Management of hyperkalemia in hospitalized patients. Lens XM,
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