hypokalemic


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Related to hypokalemic: hypokalemia, hypokalemic alkalosis, hypokalemic nephropathy, hypokalemic periodic paralysis, Hyperkalemic

hypokalemic

 [hi″po-kah-le´mik]
1. pertaining to or characterized by hypokalemia.
2. an agent that so acts.

hypokalemic

/hy·po·ka·le·mic/ (-kah-lēm´ik)
1. pertaining to or characterized by hypokalemia.
2. an agent that lowers blood potassium levels.

hypokalemia

(hi?po-ka-le'me-a) [ hypo- + L. kalium, potash + -emia]
An abnormally low concentration of potassium in the blood (less than 3.5 meq/L). Synonym: hypopotassemia See: hyperkalemiahypokalemic (-le'mik), adjective

Etiology

Causes include deficient potassium intake or excess loss of potassium due to vomiting, diarrhea, or fistulas; metabolic acidosis; diuretic therapy; aldosteronism; excess adrenocortical secretion; renal tubule disease; and alkalosis.

Symptoms

Common manifestations of mild to moderate potassium depletion include muscle aches, fatigue, or mild weakness. As potassium concentrations drop significantly below 3.0 mmol/L, ileus, paralysis, or cardiac conduction and rhythm disturbances may arise. Arrhythmias are particularly likely to affect those patients taking digoxin who become hypokalemic.

Prevention

To prevent hypokalemia, patients taking cardiac glycosides or potassium-wasting diuretics are instructed to include potassium supplements in their medical regimens. Potassium-rich foods (such as oranges, bananas, and tomatoes) are not an adequate source of the potassium that is lost by diuresis.

Treatment

Therapy consists of oral, intravenous, or combined potassium replacement.

CAUTION!

Severely hypokalemic patients may require close electrocardiographic monitoring and frequent assessment of plasma potassium levels.

Patient care

Potassium and other electrolyte levels are monitored frequently during replacement therapy to avoid overcorrection leading to hyperkalemia. Fluid balance is monitored. A physician must be notified if the patient's urine output is less than 600 ml/day because 80% to 90% of potassium is excreted through the kidneys. Cardiac rhythm is monitored, and arrhythmias are reported immediately. Additional care is taken if the patient takes a cardiac glycoside because hypokalemia enhances its action. The patient is assessed for indications of digitalis toxicity (anorexia, nausea, vomiting, blurred vision, arrhythmias). Other signs to watch for include decreased bowel sounds, abdominal distention, and constipation.

Prescribed IV potassium replacement is administered slowly with a volumetric device if the concentration exceeds 40 mEg/L. The rate should not exceed 200-250 mEg/24 hr, and the drug should never be given as a bolus because it may precipitate cardiac arrest. If the patient is prescribed a liquid oral potassium supplement, he or she is advised to dilute it in a full glass of water or fruit juice and to sip it slowly to prevent gastric irritation. Safety measures are implemented for the patient experiencing muscle weakness due to postural hypotension. The importance of taking potassium supplements as prescribed is emphasized, particularly if the patient also is prescribed a diuretic or digitalis preparation. The patient is taught signs of potassium imbalance to report, including weakness and pulse irregularities.

hypokalemic

1. pertaining to or characterized by hypokalemia.
2. an agent that lowers blood potassium levels.

feline hypokalemic polymyopathy
seen in cats with severe potassium depletion, usually caused by renal dysfunction and excessive urinary potassium losses. There is generalized muscle weakness, characterized by ventroflexion of the neck; other signs include weight loss, chronic vomiting and constipation.
Enlarge picture
Cervical ventroflexion in a cat with hypokalemic polymyopathy. By permission from Ettinger SJ, Feldman E, Textbook of Veterinary Internal Medicine, Saunders, 2004
hypokalemic nephropathy
chronic loss of potassium due to alimentary tract disease can cause vacuolar degeneration of renal tubular epithelium.
References in periodicals archive ?
In contrast, patients with alcohol-induced hypokalemic myopathy develop painless, generalized weakness (sometimes flaccid paralysis).
Thyrotoxic hypokalemic periodic paralysis:report of four cases and review of the literature.
Three of those had hypokalemic periodic paralysis caused by distal RTA.
It is important for physicians to distinguish TPP from familial hypokalemic periodic paralysis, a more common cause of periodic paralysis in Caucasians.
Abstract: Hypokalemic paralysis is a less recognized but reversible disorder in elderly patients.
In a study of 54 PAL patients in the hypertension unit of the Princess Alexandra Hospital, Brisbane, only 7 of the patients (13%) were hypokalemic, Dr.
Individuals who had been taking diuretics and were found to be hypokalemic at the screening visit were allowed to participate as described below; however, because unexplained hypokalemia in a hypertensive individual is associated with a high probability of primary aldosteronism (12), a setting where screening tests are not needed, individuals with unexplained hypokalemia were excluded from participation (a total of seven individuals: six black volunteers and one white volunteer).
In patients treated with various doses of losartan and hydrochlorothiazide, there was also a dose-related decrease in the hypokalemic response to hydrochlorothiazide as the dose of losartan was increased, as well as a dose-related decrease in serum uric acid with increasing doses of losartan.
The nation's largest independent specialty pharmacy has been named the exclusive distributor for Taro's primary hyperkalemic and hypokalemic periodic paralysis treatment, KEVEYIS(TM) (dichlorphenamide).
It is has been recently recognized that most patients with PA are not hypokalemic.
Alcohol and a variety of other agents can cause hypokalemic myopathies.