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Patient-Centered Insulin/Dextrose for Acute Hyperkalemia - #PHARMFAX

Hypoglycemia is the most preventable ADR from insulin for acute hyperkalemia.


Hypoglycemia is the most preventable ADR from insulin for acute hyperkalemia. After stabilizing the myocardium with calcium salts, we need to give insulin therapy transiently shifts potassium intracellularly. The AHA Guidelines recommend insulin regular 10 units IV for hyperkalemia in the context of cardiac arrest. We’re trying to prevent that from happening so let’s make it patient-centered. Insulin regular 10 units statistically decreases potassium greater than reduced dose strategies with higher incidences of hypoglycemia. Reduced dosing, including flat 5 units or weight-based, decreases instances of hypoglycemia without increasing cardiovascular events. Risk factors for developing hypoglycemia with insulin include kidney impairment, low BG or BMI, insulin-naive, no Hx of DM, and elderly. This risk can be mitigiated with reduced insulin and/or increased dextrose. Patients who have an initial starting BG around 100 mg/dL should receive 50gm total of dextrose rather than 25gm. Consider using insulin regular 5 units IV if the patient has more than 1 risk factor. Diggin’ the #PHARMWYZE gear? Tag a friend in the comments, and I’ll raffle off two hoodies NEXT FRIDAY, JUNE 9th! Check out another video on my page, share the #PHARMFAX with a friend, and I hope you learned something new. Recommended Read/Watch Acute Hyperkalemia Treatment Overview: Potassium Binders for Hyperkalemia : The ALL PHARMWYZE Source Follow me @pharmwyze #insulin #aha #hyperkalemia #dextrose #pharmfax #medtwitter #twitterx #medicine #sodiumbicarbonate #nursing #pharmacy #studentpharmacist #nursingstudent

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