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    27) Hypokalemia

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    Mariam Antony
    Potassium is essential for many cellular functions and its levels are tightly regulated. Hypokalemia occurs when potassium levels drop below 3.5 mmol/L and can range from asymptomatic to life-threatening. It is usually caused by inadequate intake, redistribution into cells, or excessive losses through urine or gastrointestinal routes. Treatment involves replacing losses orally or intravenously while monitoring for arrhythmias, with the method and dose depending on the severity of hypokalemia.

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    27) Hypokalemia

    Uploaded by

    Mariam Antony
    21 views29 pages
    Potassium is essential for many cellular functions and its levels are tightly regulated. Hypokalemia occurs when potassium levels drop below 3.5 mmol/L and can range from asymptomatic to life-threatening. It is usually caused by inadequate intake, redistribution into cells, or excessive losses through urine or gastrointestinal routes. Treatment involves replacing losses orally or intravenously while monitoring for arrhythmias, with the method and dose depending on the severity of hypokalemia.

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    27)Hypokalemia

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    Potassium is essential for many cellular functions and its levels are tightly regulated. Hypokalemia occurs when potassium levels drop below 3.5 mmol/L and can range from asymptomatic to life-threatening. It is usually caused by inadequate intake, redistribution into cells, or excessive losses through urine or gastrointestinal routes. Treatment involves replacing losses orally or intravenously while monitoring for arrhythmias, with the method and dose depending on the severity of hypokalemia.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    21 views29 pages

    27) Hypokalemia

    Uploaded by

    Mariam Antony
    Potassium is essential for many cellular functions and its levels are tightly regulated. Hypokalemia occurs when potassium levels drop below 3.5 mmol/L and can range from asymptomatic to life-threatening. It is usually caused by inadequate intake, redistribution into cells, or excessive losses through urine or gastrointestinal routes. Treatment involves replacing losses orally or intravenously while monitoring for arrhythmias, with the method and dose depending on the severity of hypokalemia.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    of 29

    HYPOKALAEMIA

    FATHIMA SHIFANA
    114
    Pathophysiology

    Potassium
     Most abundant intracellular cation in the human
    body
     Normal plasma level : 3.5-5.5 mmol/L
     Maintenance of k balance is essential for many
    cellular functions and neuromuscular
    transmission
     98% is located in the cell
     Intracellular k+ concentration-150
    mmol/L
     Extracellular concentration- 4-5 mmol/L
     Difference is maintained by Na+-K+
    ATPase
     Ratio of k+ concentration inside and
    outside the cell- major determinant of
    resting membrane potential
    Acid base status

    Alkalemia –promote K+ uptake by the cells


    Acidemia –diminishes K+ uptake by the cells
    Acidosis Alkalosis

    H+ K+
    K+ H+
    RENAL HANDLING OF K+
     Glomerulus – freely filtered
     PCT and thick ascending limb of henle-
    reabsorbed
     DCT and cortical collecting duct- secreted
     Excretion is increased by
     Aldosterone
     High sodium delivery to collecting duct –
    Diuretics
     High urine flow- osmotic diuresis
     High serum potassium level
    Hypokalaemia

     Defined as plasma concentration of K+ less than


    3.5 mmol/L
     Clinical manifestations of hypokalemia vary
    greatly between individual patients &their
    severity depends on degree of hypokalemia
    Mild Hypokalaemia : 3.0 – 3.5 mmol/L :
    asymptomatic
    Moderate Hypokalaemia: 2.5 - 3.0 mmol/L :
    symptomatic
    Severe Hypokalaemia <2.5 mmol/L
    PSEUDOHYPOKALAEMIA

     “Pseudohypokalemia" occurs in acute


    myelogenous leukemia
     large number of abnormal leucocytes in the
    blood specimen (stored at room temperature) –
    can take up extracellular potassium
     apparent hypokalaemia – artefact of storage
    procedure
     Clinical features
     Anorexia , Nausea
     Skeletal muscle
     Weakness
     Cramps
     Tetany
     Paralysis
     Rhabdomyolysis
     Smooth muscle
     Constipation
     Ileus
     Urinary retention
     Endocrine
     Carbohydrate intolerance
    • Cvs
    ECG changes
    Atrial or ventricular arrhythmias
    Decreased amplitude and broadening of T wave
    Prominent ‘U’ wave
    Premature ventricular contractions
    Depressed ST segments
    Causes

    Hypokalemia
    Increased loss

    Decreased Redistribution Extra


    intake into cell renal
    renal
    Decreased K intake

     Dietary – starvation
     IV therapy(potassium free)
    Redistribution into cell
     Alkalosis
     Insulin Excess
     Beta-2 agonist
     Alpha antagonist
     Hypokalemic periodic paralysis
     Hypothermia
     Barium toxicity
    Increased urinary excretion
     Activation of mineralocorticoid receptor
     Conn syndrome
     Cushing’s syndrome
     Glucocorticoid excess
     Liquorice
     Genetic disorder
     Liddle syndrome
     Bartters syndrome
     Gitelmans syndrome
     Renal tubular acidosis (type 1 and 2)
     Diuretics:
    Loop diuretics
    Thiazides
    Increased gastrointestinal loss
     Upper gastrointestinal tract
     Vomiting
     Nasogastric aspiration
     Lower gastrointestinal tract
     Diarrhoea
     Laxative abuse
     Bowel obstruction
     Ureterosigmoidostomy
    Management
     Diagnosis and treatment of the cause
     oral potassium supplements for mild to
    moderate deficiency – milk , fruit juice , tender
    coconut water
     Syrup potassium chloride – 15 ml contains 20
    mmol of potassium
     In setting of abnormal kidney function and
    mild to moderate, 20 meq/dl of oral potassium
    is generally sufficient to prevent
    hypokalaemia, but 40-100 meq/dl over a
    period of days to weeks is needed to treat
    hypokalaemia and fully replete potassium
    stores
     Intravenous potassium chloride is indicated for
    patients with severe hypokalaemia and for those
    who cannot take oral supplementation
     For severe deficiency potassium may be given
    through a peripheral intravenous line in a
    concentration up to 40 mmol/L and at rates
    upto to 10 mmol/h
     Concentration of upto 20 mmol/h may be given
    through a central venous catheter
     Continuous ECG monitoring is indicated and
    the serum potassium level should be checked
    every 3-6 hours
     Avoid glucose containing fluid to prevent
    further shifts of potassium into the cells
     Magnesium deficiency should be corrected ,
    particularly in refractory hypokalaemia
    Thank you

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