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Since most foods contain a good supply of potassium, potassium deficiency (hypokalemia) is unlikely to be caused by an unbalanced diet. Possible causes include cushing's syndrome (due to an adrenal gland disorder) and fanconi's syndrome (the result of a congenital kidney defect). The cause could also be an excessive dose of cortisone, prolonged vomiting or diarrhea, or thiazide diuretics, which are administered for treatment of hypertension. Signs of potassium deficiency can include weakness and lethargy, rapid pulse, nausea, diarrhea, and tingling sensations.
If the body absorbs enough potassium but the element is not distributed properly, various disorders may develop. Thus an abnormally low content of potassium in the blood may result in an intermittent temporary paralysis of the muscles, known as familial periodic paralysis.
Potassium deficiency can be treated by administration of potassium supplements. There is a large variety of these preparations. Some are liquids, some are powders to be dissolved in liquids, and some are slow-release tablets that dissolve in the intestine. All can cause gastrointestinal irritation. For many persons on diuretic therapy for hypertension, potassium deficiency can be avoided by increasing their consumption of potassium-containing foods, such as bananas, dates, prunes, and raisins, and potassium supplements are not needed. Potassium supplements are never given to patients receiving potassium-sparing diuretics such as amiloride, spironolactone, or triamterene. If the difficulty lies in the body's use of potassium, treatment is concerned with the primary cause of the deficiency.
Pharmacologic class: Mineral, electrolyte
Therapeutic class: Electrolyte replacement, nutritional supplement
Pregnancy risk category C
Maintains acid-base balance, isotonicity, and electrophysiologic balance throughout body tissues; crucial to nerve impulse transmission and contraction of cardiac, skeletal, and smooth muscle. Also essential for normal renal function and carbohydrate metabolism.
Tablets for effervescent oral solution: 25 mEq
Indications and dosages
➣ To prevent potassium depletion
Adults: Dosage highly individualized. Usual dosage is 25 mEq/day P.O. in divided doses.
➣ To treat potassium depletion
Adults: 50 to 100 mEq/day P.O. in divided doses, not to exceed a maximum daily dosage of 150 mEq
• Hypersensitivity to tartrazine or alcohol (with some products)
• Acute dehydration
• Heat cramps
• Hyperkalemic familial periodic paralysis
• Severe renal impairment
• Severe hemolytic reaction
• Severe tissue trauma
• Untreated Addison's disease
• Concurrent use of potassium-sparing diuretics, angiotensin-converting enzyme (ACE) inhibitors, or salt substitutes containing potassium
Use cautiously in:
• cardiac disease, renal impairment, diabetes mellitus, hypomagnesemia
• pregnant or breastfeeding patients
• children (safety and efficacy not established).
• Ensure that patient is adequately hydrated and urinating before starting therapy.
• Give with meals and a full glass of water or juice to minimize GI upset.
• Be aware that potassium preparations aren't interchangeable.
• Know that dosages are expressed in mEq of potassium and that potassium bicarbonate contains 10 mEq potassium/g.
CNS: confusion, unusual fatigue, restlessness, asthenia, flaccid paralysis, paresthesia
CV: ECG changes, hypotension, heart block, arrhythmias, cardiac arrest
GI: nausea, vomiting, diarrhea, abdominal discomfort, flatulence
Musculoskeletal: weakness and heaviness of legs
Drug-drug. ACE inhibitors, potassium-sparing diuretics, other potassium-containing preparations: increased risk of hyperkalemia
Drug-diagnostic tests. Potassium: increased level
Drug-food. Salt substitutes containing potassium: increased risk of hyperkalemia
Drug-herbs. Dandelion: increased risk of hyperkalemia
Licorice: decreased response to potassium
• Monitor renal function, fluid intake and output, and potassium, creatinine, and blood urea nitrogen levels.
☞ Be aware that potassium is contraindicated in patients with severe renal impairment and must be used with extreme caution (if at all) in patients with any degree of renal impairment, because of risk of life-threatening hyperkalemia.
• Assess vital signs. Check ECG for arrhythmias.
• Monitor neurologic status. Stay alert for neurologic complications.
• Instruct patient to dissolve tablets thoroughly in 4 to 8 oz of cold water or juice and to sip solution over 5 to 10 minutes with a meal.
• Advise patient to minimize GI upset by eating small, frequent servings of food and drinking plenty of fluids.
• Tell patient to report nausea, vomiting, confusion, numbness and tingling, unusual tiredness or weakness, or a heavy feeling in legs.
• Instruct patient to avoid salt substitutes.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, and herbs mentioned above.