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Adnexal Diseases
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Hasan Aksoy, Jordan V. Wang, Ayşe Serap Karadağ
Hormonal therapies (i.e., antiandrogens) can be helpful in women with acne, regardless of whether hyperandrogenism is present. The most commonly used agents are combined oral contraceptive pills and spironolactone. Spironolactone can cause irregular menses, breast tenderness, headaches, nausea, and hypotension. Hyperkalemia is rare, and monitoring serum potassium is not indicated in low-risk individuals.
Muscle Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Kourosh Rezania, Peter Pytel, Betty Soliven
More severe cases: Dantrolene 2 mg/kg IV q 5 min, up to 10 mg/kg: inhibits calcium release from the sarcoplasmic reticulum.Treat associated hyperkalemia.Increase ventilation.Correct the acid–base disturbance: give IV sodium bicarbonate 2–4 mg/kg.Cool the patient: cooling blankets and cold IV fluids until temperature reaches 38°C (100°F).Intravenous hydration with or without diuretics if myoglobinuria is present.Give steroids for the acute stress reaction.
Acid-Base, Electrolyte And Renal Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
The risk of adverse events associated with hyperkalaemia increases with the serum concentration level. The severity of hyperkalaemia may be defined by the serum potassium level: Mild hyperkalaemia: potassium >5.5 mmol/L.Moderate hyperkalaemia: potassium 6.0–6.5 mmol/L.Severe hyperkalaemia: potassium >6.5 mmol/L.
An evaluation of sodium zirconium cyclosilicate: a new treatment option for hyperkalaemia in China
Published in Expert Opinion on Pharmacotherapy, 2023
Yuan Lu, Bi-Cheng Liu, Hong Liu
Hyperkalemia is a common complication of chronic kidney disease (CKD), diabetes mellitus (DM), and heart failure (HF) that can cause cardiac arrhythmias or even sudden death, and is an important prognostic factor. Therefore, the management of hyperkalemia is a critical clinical issue. In China, there is a large number of patients with CKD, DM, or HF [1,2] and there is a high prevalence of hyperkalemia as a complication. A previous study showed that 3.86% of 2,997,634 outpatients in China experienced at least one episode of hyperkalemia (serum potassium >5.0 mmol/L), and the prevalence of hyperkalemia was significantly higher in outpatients with comorbid CKD, HF, DM, or hypertension (22.89%, 12.54%, 7.11%, and 6.51%, respectively) [3]. A retrospective analysis of 944,446 hospitalized patients showed that the annual incidence of hyperkalemia (>5.5 mmol/L) is 1.2% to 1.9%, with an overall incidence of 1.7% [4].
Inpatient management and post-discharge outcomes of hyperkalemia
Published in Hospital Practice, 2021
Jill Davis, Rubeen Israni, Fan Mu, Erin E. Cook, Harold Szerlip, Gabriel Uwaifo, Vivian Fonseca, Keith A. Betts
Hyperkalemia treatment was more frequent as the severity of the hyperkalemia increased. Temporizing agents were the most common treatment during the inpatient stay (mild: 28.9%; moderate: 46.0%; severe 73.0%) and intravenous calcium was the most common temporizing agent (mild: 16.5%; moderate: 29.8%; severe: 56.4%). SPS was commonly used and was used more frequently as hyperkalemia severity increased (mild: 11.7%; moderate: 27.8%; severe: 45.3%). Over a third of patients across hyperkalemia severities received diuretics (mild: 32.7%; moderate: 37.1%; severe: 34.6%). Dialysis was used by 13.3% of patients overall and use increased with hyperkalemia severity (mild: 11.3%; moderate: 14.8%; severe: 22.5%). Treatment with patiromer was rare during the inpatient stay (<0.1% overall) and very few patients were prescribed SPS (0.1%) or patiromer (<0.1%) at discharge.
Patiromer for the treatment of hyperkalemia
Published in Expert Review of Clinical Pharmacology, 2020
Gates B. Colbert, Dhwanil Patel, Edgar V. Lerma
Almost all guidelines call for renin-angiotensin aldosterone inhibitors (RAASi) as first-line therapy to prevent the progression of CKD, HTN, and CVD [5,8,9]. Unfortunately, these medications often lead to hyperkalemia with increased dosing titration or in combination, despite their proven records of decreasing overall comorbidity and mortality. This leads to a reduction or complete cessation of RAASi, leaving patients without protective medications previous trials have shown to be beneficial. This has been documented in a study that showed HF patients with reduced ejection fraction who received less than half the recommended doses of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) and beta-blockers had a greater risk of death and/or hospitalization compared to patients who receive the recommended dosages [10]. Several clinical trials have stopped early due to hyperkalemia associated with maximizing RAASi [11]. One of the first recommended treatment options if hyperkalemia occurs is to restrict potassium intake to less than 2400 mg/day. Unfortunately this can lead to increased sodium intake, which should be less than 2300 mg/day in high-risk patients [12]. It is extremely restrictive and difficult to maintain both low potassium and low sodium diet in the Western world. Thus, patients who experience hyperkalemia are left with reducing medications that are shown to be beneficial, and frequently recommended a diet that is difficult to maintain.