Pharmacotherapy Electrolytes Part 2

Front 1

t/f
renal failure can cause hyperkalemia

Back 1

true

Front 2

t/f
aldosterone is effected by hyperkalemia

Back 2

true
impaired tubular responsiveness to aldosterone

Front 3

___ is the clenching and unclenching of fists during venipuncture

Back 3

pseudohyperkalemia

Front 4

t/f

hyperkalemia frequently has no symptoms

Back 4

true blue with a side of ew
green mean with a taste of cream

Front 5

Palpitations and other arrhythmias occur in hyper or hypo kalemia?

Back 5

hyperkalemia

Front 6

*** key

in hyperkalemia, emergent treatment occurs when K>___mEq/L or >___mEq/L with symptoms / EKG changes

Back 6

in hyperkalemia, emergent treatment occurs when K>7 mEq/L or > 6.1 mEq/L with symptoms / EKG changes

Front 7

what do you give (2 things) or do (1 thing) in hyperkalemia, emergent treatment occurs when K>7 mEq/L or > 6.1 mEq/L with symptoms / EKG changes ?

Back 7

Give :
1) CaCl or gluconate IV
-MOA antagonizes membrane actions of K and restores normal Cardiac function

2) promotion of intracellular shift
-insulin/glucose, albuterol, NaI ICO3

3. Hemodialysis

Front 8

t/f
B-blockers causes hyperkalemia

Back 8

true

Front 9

t/f
hypokalemia causes impaired tubular responsiveness to aldosterone

Back 9

false, hyperkalemia

Front 10

true/false
insulin/glucose, albuterol, and NaI ICO3 antagonize membrane actions of K to treat hyperkalemia

Back 10

false,
insulin/glucose, albuterol, and NaI ICO3 promote intracellular shift to treat hyperkalemia

Front 11

what are the two nonemergent treatments of hyperkalemia?

Back 11

Loop diuretics
-MOA increase renal K excreation
-onset - minutes; duration - 4 to 6 hrs
-starting dose + furosemide (20-40 mg PO)

and

sodium polystyrene sulfonate
-MOA - ion exchange resin (1 Gm exchanges 1 meq Na for 1 meq K)
-onset - 1 to 2 hrs; repeat every 4 hrs prn
-usual dose 15-60 Gm po q 4-6 hr

Front 12

what is the MOA of Sodium polystyrene?

Back 12

ion exchange resin (1 gm exchanges 1 meq NA for 1 meq K)

Front 13

what is the dose of sodium polystyrene sulfonate?

Back 13

15-60 gm po q 4 to 6 hr

Front 14

what is the onset of sodium polystyrene sulfonate

Back 14

1 to 2 hrs

Front 15

what is the 2nd most abundant intracellular cation

Back 15

Mg

Front 16

what is considered "natures physiologic calcium channel blocker"

Back 16

Mg

Front 17

what are normal serum Mg levels?

Back 17

1.4 - 1.8 mEq/L

Front 18

what are the three therapeutic uses of Mg?

1.diabetes
2.preeclampsia
3.depression
4.delerium tremens
5.cardia arrhythmias
6. diuretic
7.brain tumor

Back 18

cardiac arrhythmias
preeclampsia
delerium tremens

Front 19

hypomagnesium is commonly seen in conjunction with ____ and _____

a-hypocalcemia
b-hyponatremia
c-hypophoshoremia
d-hypokalemia

Back 19

hypokalemia and hypocalcemia

Front 20

t/f
alcoholism causes hyperkalemia

Back 20

false ,
alcoholism causes hypomagnesium

Front 21

a cause of hypomagnesemia is digoxin which causes? causes renal loss

Back 21

causes renal loss

Front 22

t/f
a decrease in phosphate causes an increase in magnesium

Back 22

false
a decrease in phosphate causes a decrease in magnesium

Front 23

at what level are symptoms seen in hypomagnesemia?

Back 23

<1 mEq/L

Front 24

if Mg serum levels are <1 mEq/L or symptomatic
what two treatment methods are used?

Back 24

MgSO4 via IV route

Dilute in NS

Front 25

if Mg serum levels are >1 mEq/L and w/o symptoms, what three methods of treatment are used?

Back 25

milk of magnesia
-5 ml QID PO
Mg-containing antacids
-15mL TID PO
magnesium oxide tablets
-400 - 800 mg QID

Front 26

what is the dosing for magnesium oxide tablets?

Back 26

400- 800 mg QID

Front 27

what is the dosing of Milk of magnesia?

Back 27

5ml QID PO

Front 28

what is the dosing of Mg-containing antacids?

Back 28

15mL TID

Front 29

When treating hypermagnesemia you give what type of IV?

Back 29

Ca, it antagonizes the effects of Mg....

do the same thing in Hyper k and hypo Ca

Front 30

t/f
hemodialysis is a form of treatment in hypermagnesemia in ESRD

Back 30

true

Front 31

what is the total body content of Ca?

Back 31

1200g

Front 32

where is 99% of Ca found in the body?

Back 32

bones

Front 33

where is <0.5% of Ca found in the body?

extracellular or intracellular

Back 33

extracellular

Front 34

what are normal Serum Ca levels?

Back 34

8.5 - 10.5 mg/dL

Front 35

t/f

serum levels represent bound and unbound Ca

Back 35

true

Front 36

what is Ca closely regulated by?

Back 36

parathyroid

Front 37

Vitamin D deficit diets can cause hypocalcemia?

Back 37

true

Front 38

t/f
hypoparathyroidism cause hypercalcemia

Back 38

false, hypoparathyroidism causes hypocalcemia

Front 39

a cause of hypocalcemia is hypomagnesium

Back 39

true

Mg~Ca~K

Front 40

t/f
calcitonin causes hypo or hyper calcemia?

Back 40

hypocalcemia

Front 41

loop diuretics cause hypo or hyper calcemia?

Back 41

hypocalcemia

Front 42

t/f
bisphosphonates, phenobarbital, phenytoin all cause hypocalcemia?

Back 42

true

Front 43

what type of IV is used to treat hypocalemia?

Back 43

IV calcium chloride or Gluconate

do not exceed 60mg/min

Front 44

what is the max Mg/min of IV calcium chloride or gluconate when treating hypocalemia?

Back 44

60 mg/min

Front 45

t/f
use oral calcium +/- Vit D when a patient is symptomatic hypocalcemia

Back 45

false

t/f
use oral calcium +/- Vit D when a patient is ASYMPTOMATIC hypocalcemia

Front 46

what is the starting dose of Oral calcium when treating hypocalcemia?

Back 46

1-3 g/dayof elemental Ca

Front 47

what type of dietary modifications should a patient with hypocalcemia make? (two things decrease Ca levels, what are they?)

Back 47

caffeine and phosphorus decrease Ca levels

Front 48

Paraneoplastic syndromes are associated with what electrolyte imbalance?

Back 48

hypercalcemia

Front 49

Vitamin D toxicity can cause Hyper or hypo calcemia?

Back 49

hypercalcemia

Front 50

deposits of Ca in multiple organs and blood vessels contributes to ___disease

Back 50

cardiac disease

Front 51

when do symptoms appear in hypercalcemia?

Back 51

when levels >13 mg/dL

Front 52

t/f
you want to increase blood volume in hypercalcemia treatment?

Back 52

true (increases Ca excretion)

Front 53

do you give a loop or thiazide diuretic to a pt with hypercalcemia?

Back 53

loop diuretic after rehydration is complete

Front 54

What is calcitonin used for?

Back 54

treating hypercalcemia

Front 55

what is calcitonin usually comboed with?

Back 55

bisphosphonates which decrease bone resorption, Ca levels begin to decline after 2 days of taking bisphosphonates

Front 56

what do you use Gallium nitrate for?

Back 56

hypercalcemia

Front 57

what is the most useful situation for gallium nitrate?

Back 57

malignancy, symptoms and no response to hydration

Front 58

how does gallium nitrate work ?

Back 58

it inhibits bone reabsorption in hypercalcemia like bisphosphonates (zoledronate, etidronate, pamidronate, and ibandronate)

Front 59

t/f
Gallium nitrate is the first choice when treating hypercalcemia

Back 59

false
but i don't know what is :/

Front 60

who is the most beautiful princess in the world?

Back 60

cinderella

wait..real world..eee...umm...o yeah..BRITTTANNNNYYY

Front 61

what is mithramycin used for?

Back 61

hypercalcemia

nephrotoxic and hepatotoxic though

Front 62

what is the onset of mithramycin used in hypercalcemia?

Back 62

12hrs and peak effects are 48-96 hrs

Front 63

corticosteroids are commonly used in what electrolyte imbalance?

Back 63

purple drank?

hypercalcemia, most useful with multiple myeloma, leukemia, and sarcoid

decrease GI Ca absorption, increase urinary Ca excretion, and decrease bone reabsorption

Front 64

what is the "principle intracellular anion"

Back 64

phosphorus

Front 65

what is the primary source of ATP

Back 65

phosphorus

Front 66

what are the normal serum levels or phosphorus?

Back 66

2.5 -4.5 mg/dL

Front 67

would you like some grape juice?

Back 67

JUICE! W....T......F...... IS JUICE!??!?!?!?

Front 68

Vitamin D deficiency can cause hypo or hyper phosphatemia?

Back 68

hypophosphatemia

Front 69

sevelamer can cause hypo or hyperphosphatemia?

Back 69

hypophosphatemia

along with Sucalfate, Ca or Al or Mg antacids, and lanthanum

Front 70

we've got soda, water, ahh ALRighT! SUNNY-D!

Back 70

..i want sum uv that purple stuff

Front 71

does dextrose/insulin, glucagon, epinephrine, respiratory alkalosis, and re-feeding syndrome cause and intra or extracellular shift of phosphorus leading to hypophoshatemia.

Back 71

intracellular shift of phosphorus

Front 72

what is considered severe hypophosphatemia?

Back 72

<1 mg/dL or symptomatic

normal range - 2.5-4.5

Front 73

how do you treat severe hypophosphatemia?

Back 73

IV supplementation

Front 74

how much and how fast do you run a phosphorus IV?

Back 74

9 to 15 mmol over 4-12 hrs

Front 75

t/f
Phosphorus IV will cause in increase risk of Hypocalemia, hypomagnesemia, metastatic soft tissue, CaPO4 deposition

Back 75

true

Phosphorus IV will cause in increase risk of Hypocalemia, hypomagnesemia, metastatic soft tissue, CaPO4 deposition

Front 76

what is the oral dose of phosphorus?

Back 76

1-2 Gm daily

Front 77

t/f

Ca, Ma, or Al antacids increase effect of a K oral supplement

Back 77

false,
Ca, Ma, or Al antacids DECREASE effect of a K oral supplement

Front 78

t/f
you commonly see hyperphosphatemia with hypocalcemia?

Back 78

true