Potassium disorders

The body s normal daily potassium requirement is 0.5 to 1 mEq/kg (0.5 to 1 mmol/kg) or 40 to 80 mEq (40 to 80 mmol) to maintain a serum potassium concentration of 3.5 to 5 mEq/L (3.5 to 5 mmol/L). Potassium is the most abundant cation in the ICF, balancing the sodium contained in the ECF and maintaining electroneutrality of bodily fluids. Because the majority of potassium is intracellular, serum potassium concentration is not a good measure of total body potassium however, clinical manifestations of potassium disorders correlate well with serum potassium. The acid-base balance of the body affects serum potassium concentrations. Hyperkalemia is routinely seen in... 

Alfonzo AVM, Isles C, Geddes C, Deighan C. Potassium disorders - clinical spectrum and emergency management. Resuscitation 2006 70(l) 10-25. 

The molten carbonate fuel ceU uses eutectic blends of Hthium and potassium carbonates as the electrolyte. A special grade of Hthium carbonate is used in treatment of affective mental (mood) disorders, including clinical depression and bipolar disorders. Lithium has also been evaluated in treatment of schizophrenia, schizoaffective disorders, alcoholism, and periodic aggressive behavior (56). 

Other Potassium and Sodium Disorders. Potassium and/or sodium deficiency can lead to muscle weakness and sodium deficiency to nausea. Hyperkalemia resulting in cardiac arrest is possible from 18 g/d of potassium combined with inadequate kidney function. Faulty utilisation of K" and/or Na" can lead to Addison s or Cushing s disease. 

Potassium Iodide. When potassium iodide [7681-11-0] is adrninistered orally for several (6—8) weeks, a therapeutic effect may be obtained ia the subcutaneous form of sporotrichosis. Amphotericin B is used iatravenously to treat systemic sporotrichosis. The KI dosage is usually a saturated solution ia water (1 g/mL). The usual oral dose is 30 mg/kg/d. Children should receive five droplets, three times a day (after meals) the dose may be iacreased to 15—20 droplets. Side effects iaclude digestive disorders, swelling of the saUvary glands, and lacrimation. Thyroid function tests may be disturbed. 

The crystallographic study of the potassium salt is complicated by disorder but in CsOs03N Os=N is 1.676 A and Os=0 1.739-1.741 A. Assignments of the vibrational spectrum of Os03N is assisted by isotopic substitution the higher frequency absorption is shifted significantly on 15N substitution whereas the band just below 900 cm-1 is scarcely affected (Table 1.7) conversely the latter band is shifted by some 50 cm-1 on replacing l60 by l80 [56], Nitrido salts are discussed later (section 1.12.2). 

Potassium Channels. Table 1 Human K+ channel auxiliary subunits genes, localization, function, and disorders... 

Potassium nitrate dissolves readily in water, and its enthalpy of solution is +34.9 kj-niol. (a) Does the enthalpy of solution favor the dissolving process (b) Is the entropy change of the system likely to be positive or negative when the salt dissolves (c) Is the entropy change of the system primarily a result of changes in positional disorder or thermal disorder ... 

Lithium compounds are used in ceramics, lubricants, and medicine. Small daily doses of lithium carbonate are an effective treatment for bipolar (manic-depressive) disorder but scientists still do not fully understand why. Lithium soaps—the lithium salts of long-chain carboxylic acids—are used as thickeners in lubricating greases for high-temperature applications because they have higher melting points than more conventional sodium and potassium soaps. 

The major mineralocorticoid, aldosterone, is secreted by cells of the zona glomerulosa. Primary hyperaldosteronism (Conn s syndrome) is associated with potassium depletion which is, in mm, responsible for the observed neuromuscular abnormalities seen in the disorder. These are similar to those seen in hypokalemic periodic paralysis (PP), with episodic and severe exacerbations of fixed muscle weakness. Muscle biopsy shows occasional muscle necrosis and vacuoles often these feamres are accompanied by mbular aggregates as in hypokalemic PP. All these changes can be attributed to the hypokalemia and not to excess aldosterone production per se. 

Any time an ABG is analyzed it is wise to concurrently inspect the serum chemistry values to calculate the anion gap. The body does not generate an anion gap to compensate for a primary disorder. As such, if the calculated anion gap exceeds 12 mEq/L (mmol/L) there is a primary metabolic acidosis regardless of the pH or the serum HC03 concentration. The anion gap may be artificially lowered by decreased serum albumin, multiple myeloma, lithium intoxication, or a profound increase in the serum potassium, calcium, or magnesium. 

The metabolic component of mixed respiratory and metabolic alkalosis should be corrected by administering sodium and potassium chloride solutions. The respiratory component should be treated by readjusting the ventilator or by treating the underlying disorder causing hyperventilation. 

Fluid and electrolyte homeostasis is maintained by feedback mechanisms, hormones, and many organ systems and is necessary for the body s normal physiologic functions. Disorders of sodium and water, calcium, phosphorus, potassium, and magnesium homeostasis are addressed separately in this chapter. 

See Chap. 52, Disorders of Sodium and Water Homeostasis, authored by James D. Coyle and Melanie S. Joy Chap. 53, Disorders of Calcium and Phosphorus Homeostasis, authored by Amy Barton Pai, Mark Rohrscheib, and Melanie S. Joy and Chap. 54, Disorders of Potassium and Magnesium Homeostasis, authored by Donald F. Brophy and Todd W. B. Gehr, for a more detailed discussion of this topic... 

Subcutaneous administration of -hexanc at 143 mg/kg/day for 30 days has been reported to decrease the threshold for ventricular fibrillation in perfused hearts from male Wistar rats (Khedun et al. 1996). Myocardial magnesium and potassium levels were reduced in treated rats. When these levels were corrected by supplementation, the ventricular fibrillation potential was still reduced. Histological alterations (disordered myocardial Z-bands) were also observed in exposed rats. 

Figure 3. The many ways to lose a HAT. Decreased amounts of functional CBP protein and subsequent CBP s loss of function has been observed in different contexts of neurological disorders and neuronal apoptosis. RTS (Rubinstein-Taybi Syndrome) results from a mutation on one cbp gene allele. In several cases of polyQ diseases, CBP can be sequestred by the mutated polyQ proteins, forming aggregates in the cytoplasm or the nucleus. CBP proteasomal degradation was also shown to be favored by polyQ proteins. CBP is a caspase-6 substrate in cerebellar granule neurons (CGN) deprived of potassium modeling caspase-dependent apoptosis. Finally, cbp gene repression has been observed in oxidative stress-induced death of a motomeuronal cell line. The mechanisms by which CBP levels are reduced in motomeurons of ALS mice is still unknown...

The clinical effects of chloroform toxicity on the central nervous system are well documented. However, the molecular mechanism of action is not well understood. It has been postulated that anesthetics induce their action at a cell-membrane level due to lipid solubility. The lipid-disordering effect of chloroform and other anesthetics on membrane lipids was increased by gangliosides (Harris and Groh 1985), which may explain why the outer leaflet of the lipid bilayer of neuronal membranes, which has a large ganglioside content, is unusually sensitive to anesthetic agents. Anesthetics may affect calcium-dependent potassium conductance in the central nervous system (Caldwell and Harris 1985). The blockage of potassium conductance by chloroform and other anesthetics resulted in depolarization of squid axon (Haydon et al. 1988). 

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