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  • • Depressed serum potassium

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Epidemiology

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  • • Alcoholics

    • Elderly

    • Prolonged NPO

    • Hyperaldosteronism

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Symptoms and Signs

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  • • Decreased muscle contractility

    • Paralysis

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Laboratory Findings

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  • • Depressed serum potassium

    • Alkalosis can contribute

    • Hypomagnesemia can contribute to refractoriness

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  • • Laboratory error or difficulty with phlebotomy; blood drawn from above an IV infusion can have spurious results with very low potassium

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Rule Out

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  • • Hypomagnesemia

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  • • Serum electrolytes including magnesium

    • ABG (pH) measurement

    • Urine potassium losses: (< 30 mEq/d total body deficit, > 30 mEq/d renal wasting)

    • Plasma renin activity, serum aldosterone measurement

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  • • Correct underlying problem

    • Potassium repletion

    • Magnesium repletion if necessary

    • Correct alkalosis if present

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Medications

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  • • KCl PO if possible, if IV then 20-30 mEq/h by central vein or 10 mEg/h by peripheral vein

    • MgSO4

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Treatment Monitoring

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  • • Serum potassium

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Complications

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  • • Hyperkalemia

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Prognosis

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  • • Excellent

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Prevention

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  • • Adequate dietary intake or IV supplements

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References

Schaefer TJ. Wolford RW. Disorders of potassium. Emergency Medicine Clinics of North America 2005, 23(3):723-47, viii-ix.  [PubMed: 15982543]

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