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Pseudohyperkalemia, due to breakdown of cells during or after taking the blood sample, should be ruled out. [1] [2] Initial treatment in those with ECG changes is salts, such as calcium gluconate or calcium chloride. [1] [3] Other medications used to rapidly reduce blood potassium levels include insulin with dextrose, salbutamol, and sodium ...
There are three mainstays of treatment of hyperkalemia. These are stabilization of cardiac cells, shift of potassium into the cells, and removal of potassium from the body. [3] [14] Stabilization of cardiac muscle cells is done by administering calcium intravenously. [3]
Insulin is also used along with glucose to treat hyperkalemia (high blood potassium levels). [7] Typically it is given by injection under the skin, but some forms may also be used by injection into a vein or muscle. [6] There are various types of insulin, suitable for various time spans.
AstraZeneca's (AZN) Lokelma secures an FDA approval for the treatment of hyperkalemia in adults.
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10% calcium gluconate solution (given intravenously) is the form of calcium most widely used in the treatment of low blood calcium.This form of calcium is not as well absorbed as calcium lactate, [12] and it only contains 0.93% (93 mg/dL) calcium ion (defined by 1 g weight solute in 100 mL of solution to make 1% solution w/v).
However, if hyperkalemia causes any ECG change it is considered a medical emergency [12] due to a risk of potentially fatal abnormal heart rhythms and is treated urgently. [12] Potassium levels greater than 6.5 to 7.0 mmol/L in the absence of ECG changes are managed aggressively. [12] Several approaches are used to treat hyperkalemia. [12]
Patiromer was generally well tolerated in studies. Side effects that occurred in more than 2% of patients included in clinical trials were mainly gastro-intestinal problems such as constipation, diarrhea, nausea, and flatulence, and also hypomagnesemia (low levels of magnesium in the blood) in 5% of patients, because patiromer binds magnesium in the gut as well.