157 - Everything Will Be ao-K+: Potassium Formulations and Dosing for Hypokalemia

HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast

Sean P. Kane, PharmD, BCPS

Health & Fitness, Medications, Rosalindfranklin, Rfums, Pharmacy, Pharmd, Pharmacist, Medicine, Drugs

5 • 644 Ratings

🗓️ 29 November 2022

⏱️ 38 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, we review the management of a patient with hypokalemia, including both inpatient and outpatient supplementation with potassium chloride supplements and what dosage forms are available for potassium repletion.

Key Concepts

Most diets will provide sufficient potassium to avoid hypokalemia. Hypokalemia usually occurs due to drug therapy (such as diuretics) or GI losses from severe vomiting or diarrhea.
In patients with chronically low potassium, supplements are dosed to increase dietary intake of potassium by about 20-40 mEq per day. For acute repletion, 10 mEq of potassium should increase serum potassium by about 0.1 mEq/L.
Over-the-counter potassium (as potassium gluconate) contains a very small amount of potassium (2.5 mEq). Potassium chloride powders and liquids (like salt substitutes) taste terrible and are poorly tolerated. Most patients will replete potassium via slow-release tablets (Klor-Con or Klor-Con M) or via potassium chloride IV infusions.
Most IV fluids do not contain any potassium at all (or very little potassium). Patients receiving these IV fluids who are NPO will eventually become hypokalemic. Certain maintenance fluids do contain potassium – most patients will receive about 40 mEq of potassium per day with these IV fluids.

Transcript

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0:00.0	Welcome to Helix Talk, an educational podcast for healthcare students and providers covering real-life clinical pearls, professional pharmacy topics, and drug therapy discussions.
0:11.0	This podcast is provided by pharmacists and faculty members at Rosal Franklin University College of Pharmacy.
0:17.0	This podcast contains general information for educational purposes only. This is not professional
0:22.4	advice and should not be used in lieu of obtaining advice from a qualified health care provider.
0:27.2	And now on to the show. Welcome to Helix Talk episode 157. I'm your co-host Dr. Kane.
0:35.8	And I'm Dr. Patel. And the title of today's episode is
0:39.2	everything will be A-O-K, potassium formulations and dosing for hypokalemia. This is actually a listener
0:46.5	requested topic, Dr. Patel. So the listener wanted to know more about potassium supplementation
0:51.5	in terms of what products are available and how you dose it
0:54.6	for hypochalemia or a low potassium patient. So we've kind of taken that and run with it a little bit
0:59.5	today in terms of how do you know a patient has low potassium? What do you do about it? And then also on
1:04.9	the inpatient side, we're going to talk a little bit about IV fluids and how you discern which
1:09.6	ones have potassium and which ones don't and how it's given
1:12.2	to patients as well.
1:14.0	Great.
1:14.4	It looks like we have a good mix of both outpatient and inpatient strategies for hypokulemia.
1:19.3	So let's get to it.
1:20.7	So we'll start with a patient case.
1:22.6	So we'll just call this patient George.
1:24.4	He's a 60-year-old man.
1:25.9	He was recently diagnosed with heart failure with preserved
1:28.8	ejection fraction. And for his edema, he was given furoasemite or LASICs 40 milligrams once daily.
	...

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