Hyperkalemia Management: Preventing Hypoglycemia From Insulin

 

DID YOU KNOW: The hypoglycemic effects of IV insulin last longer than a bolus of dextrose when correcting hyperkalaemia. 50 mL (25 gm) of 50% Dextrose is not enough to counteract the hypoglycemic effect of insulin in patients with normoglycemia to start.  Make sure to check glucose at the hour mark after administering IV insulin. Insulin’s peak effect occurs at about 60 minutes and this is when hypoglycemia has most often been reported in the literature.

Mythbuster: Calcium Gluconate Raises Serum Calcium as Quickly as Calcium Chloride

The Calcium debate for Hyperkalaemia… As long as equivalent doses are used, calcium gluconate works as quickly (and to the same degree) as CaCl2 to raise calcium concentration… without the same extravasation risk.

Is Kayexalate Useful in the Treatment of Hyperkalemia in the Emergency Department?

Kayexalate in Hyperkalaemia – A review of the literature shows that there is virtually NO BENEFIT in the emergent setting to the use of kayexalate. But is there a downside? As with all medications, there is. In this case, there is a rare but highly lethal complication of the drug: Colonic Necrosis.