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2022 JUN 11 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators publish new report on Nutritional and Metabolic Diseases and Conditions - [...]

We report a case of severe hypokalemia and flaccid muscle paralysis following a suicide attempt associating the calcium channel blocker amlodipine, the antidepressant fluoxetine and barium carbonate. Despite rapid correction of severe, life-threatening hypokalemia, areflexic quadriplegia persisted, suggesting a direct effect of barium on muscle cells. Continuous veno-venous hemodiafiltration (CVVHDF) was initiated. We determined barium concentration in the urine, plasma, and hemodiafiltrate during CVVHDF. We subsequently calculated the amounts of barium eliminated both by the CVVHDF and the kidneys. CVVHDF triples the measured barium elimination, reduced serum barium half-life by a factor of three, stabilized serum potassium levels, and rapidly improved motor strength, with complete neurological recovery within 24h. Presentation and treatment of barium intoxication are discussed. Key Words: Barium intoxication; Suicide; Hypokalemia; Quadriplegia; Muscle paralysis; Arrhythmias; Hemodiafiltration; CVVHDF., INTRODUCTION Barium intoxication is a rare, life-threatening situation. Clinical manifestations range from digestive symptoms such as abdominal pain, nausea, vomiting, and diarrhea to severe cardiac arrhythmias and hypertension. Within hours [...]

Disturbances in potassium homoeostasis presenting as low or high serum potassium are common, especially among hospitalised patients. Given the fact that untreated hypokalaemia or hyperkalaemia is associated with high morbidity [...]

Background: While administrative databases are used to assess general indicators of quality of care, a detailed audit of the process of clinical care usually requires review of hospital medical records. Objective: To evaluate the feasibility of assessing the management of severe hypokalemia using computerized administrative and laboratory databases. Methods: The study included all patients hospitalized in 1997 who experienced serum potassium levels of less than 3.0 mmol/L at Hadassah University Hospital, Jerusalem, Israel, a tertiary care center. Using the computerized databases, we measured the following: (1) whether a subsequent serum potassium test was performed, (2) time to the subsequent test and to normalization of the serum potassium level, (3) achievement of normokalemia, and (4) in-hospital mortality. In a random subsample of 100 patients, these measures were compared with the blinded assessment of the quality of medical management of hypokalemia, as determined from medical records, using predetermined criteria for adequate management. Results: The computerized databases revealed that severe hypokalemia occurred in 866 patients (2.6% of the yearly hospitalizations): 55 patients (6.4%) had no subsequent serum potassium levels measured, and 260 (30.0%) were discharged from the hospital with a subnormal potassium level. The mean time to a subsequent test was 20 hours, and to normokalemia, 50 hours; both intervals varied by department. In-hospital mortality was 20.4%, or 10-fold that of the entire hospitalized population. A review of hospital medical records revealed inadequate clinical management of hypokalemia in 24%, which was associated with nonperformance of a subsequent test (likelihood ratio, 8.4), failure to normalize the serum potassium level (likelihood ratio, 4.2), discharge from the hospital with a subnormal potassium level (likelihood ratio, 2.1), and in-hospital death (likelihood ratio, 2.5), all of which could be determined by the computerized databases. Conclusions: The computerized laboratory database is useful in ascertaining the prevalence of severe hypokalemia and in assessing shortcomings in its management. Databases can be used to derive valid and efficient measures of the quality of the clinical management of electrolyte disorders. Arch Intern Med. 2001;161:1089-1095

Regulation of potassium concentrations within very narrow confines (3.5 to 5.2 mEq/L) is crucial to the maintenance of life. From the second to second discharge of cardiac pacemaker tissue that […]

* Experimental and clinical observations support the view that uncorrected magnesium (Mg) deficiency impairs repletion of cellular potassium (K). This is consistent with the observed close association between K and Mg depletion. Concomitant MG deficiency in K-depleted patients ranges from 38% to 42%. Refractory K repletion due to unrecognized concurrent Mg deficiency can be clinically perplexing. Refractory K repletion as a consequence of Mg deficiency may be operative in patients with congestive failure, digitalis toxicity, cisplatin therapy, and in patients receiving potent loop diuretics. Therefore, we recommend that: (1) serum Mg be routinely assessed in any patients in whom serum electrolytes are necessary for clinical management and (2) until serum Mg is routinely performed consideration should be given to treating hypokalemic patients with both Mg as well as K to avoid the problem of refractory K repletion due to coexisting Mg deficiency. (Arch Intern Med. 1992;152:40-45)

Hypokalemia is a medical condition that occurs when the serum potassium level falls below 3.5 mEq./L. Serum potassium falls due to certain illnesses, intake of certain drugs or malnutrition. Oral or intravenous potassium should be administered slowly unless the patient is in grave condition due to the hypokalemic state., The second article in our electrolyte series focuses on potassium deficit, a serious condition that demands your prompt recognition and intervention. Hypokalemia develops in both healthy and chronically ill patients [...]

Table of Contents Abstract Case Report Discussion Conclusion References Abstract The oral cavity is the site of many infectious and inflammatory disease. Systemic diseases have been recently been associated with [...]

Table of Contents Abstract Case Report Discussion Conclusion References Abstract A 28year old normotensive euthyroid male presented with recurrent lower motor neuron type of weakness without any sensory or autonomic [...]

Table of Contents Abstract Introduction Case 1 Case 2 Discussion References Abstract Hypokalemia is usually asymptomatic and goes undetected. Or it may manifest as muscular weakness, fatigue, abdominal distension. Severe [...]

The possible causes, signs, and symptoms of hypokalemia that includes increased aldosterone production responsible for potassium excretion in the urine, vomiting, fatigue, and others are discussed. The treatment for hypokalemia aiming to correct the potassium deficit and minimize potassium losses is also suggested.

Mary Allen describes a case of drug-induced hypokalaemia Objectives * To revise the causes of hypokalaemia * To be aware of which diuretics might be to blame * To be [...]

A pharmacists investigates drugs including diuretics and potassium supplements for a woman diagnosed with hypokalaemia., Christine Johnson is a pleasant middle-aged woman who walked into Jill's community pharmacy one afternoon with a prescription. Jill had not been working in the pharmacy for long, but the [...]

PRESCRIBING NOTES POTASSIUM SUPPLEMENTS Solutions are the preferred formulations, but if they are refused or not tolerated, tablets may be used. Indications: Hypokalemia, including that caused by diuretics. Digitalis intoxication [...]

Evan Robertson was rushed to a hospital due to hypokalemia. Steps nurses should take for Robertson's treatment and discharge are also discussed.

Cisplatin is an anticancer drug that has been found to reduce levels of magnesium and potassium in patients treated by chemotherapy by increasing kidney secretion of these ions. The loss of appetite that is associated with anticancer chemotherapy can further reduce the level of these ions because of low food intake. Two cases of severe magnesium and potassium depletion in cisplatin-treated patients are reported, and physicians are reminded of the necessity to routinely assess cisplatin-treated patients for magnesium and potassium levels. The depletion of potassium is often resistant to treatment in the absence of adequate magnesium. When such resistance is seen, as in the two patients reported, levels of magnesium should be investigated.