Hyperkalemia albuterol

Patients with acute hyperkalemia usually require other therapies to manage hyperkalemia until dialysis can be initiated. Patients who present with cardiac abnormalities caused by hyperkalemia should receive calcium gluconate or chloride (1 g intravenously) to reverse the cardiac effects. Temporary measures can be employed to shift extracellular potassium into the intracellular compartment to stabilize cellular membrane effects of excessive serum potassium levels. Such measures include the use of regular insulin (5 to 10 units intravenously) and dextrose (5% to 50% intravenously), or nebulized albuterol (10 to 20 mg). Sodium bicarbonate should not be used to shift extracellular potassium intracellularly in patients with CKD unless severe metabolic acidosis (pH less than 7.2) is present. These measures will decrease serum potassium levels within 30 to 60 minutes after treatment, but potassium must still be removed from the body. Shifting potassium to the intracellular compartment, however, decreases potassium removal by dialysis. Often, multiple dialysis sessions are required to remove potassium that is redistributed from the intracellular space back into the serum. 

The definitive treatment of severe hyperkalemia in ESRD is hemodialysis. Temporary measures include calcium gluconate, insulin and glucose, nebulized albuterol, and sodium polystyrene sulfonate. 

Rapid correction of hyperkalemia requires administration of drugs that shift potassium intracellularly (e.g., insulin and dextrose, sodium bicarbonate, or albuterol). 

Li i effects OF digitalis EMS Monitor ECG for hyperkalemia (peaked T waves), esp in pts taking ACEIs and K-suppl may T glucose T risk of photosensitivity Rxns may turn urine a blue color OD May cause electrolyte disturbances and dehydration NaHC03 and nebulized albuterol can be used to lower K+... 

Albuterol is used as a bronchodilator in the treatment of asthma. Albuterol is also used in the prevention of premature labor. Off label uses include treatment of hyperkalemia. 

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