The treatment of choice in acute hyperkalemia of life threatening to cardiac myocytes is -: (A) Infusion of calcium gluconate, (B) Oral resins, (C) Intravenous infusion of insulin, (D) P blocker
Answer is A. Ans. is 'a' i.e. Infusion of calcium gluconate EMERGENCYModalityMechanism of actionOnsetDurationCalcium gluconateAntagonizes cardiac conduction abnormalities0-5 minutes1 hourSodium BicarbonateDistributes K+ into cells(only indicated with acidosis)15-30 minutes1 -2 hoursInsulinDistributes K+into cells15-60 minutes4-6 hoursAlbuterolDistributes K+ into cells15-30 minutes2-4 hoursNONEMERGENCYModalityMechanism of actionDuration of treatmentLoop diuretic| Renal K4 excretion0.5-2 hoursSodium polystyrene sulfonate (kayexalate)Ion-exchange resinbinds K+1 -3 hoursHemodialysisExtracorporeal K+removal48 hoursPeritoneal dialysisPeritoneal K+ removal48 hours