Electrolyte and Acid-Base Disturbances
John K. DiBaise, Carol Rees Parrish, Jon S. Thompson in Short Bowel Syndrome Practical Approach to Management, 2017
IV potassium supplementation is highly effective, although it carries risks. The most serious risk associated with IV potassium is arrhythmia, which is closely associated with the rate of infusion. As a general rule, the rate of potassium infusion should never exceed 10 mEq/hour in the absence of continuous electrocardiographic monitoring. Infusion rates >10 mEq/hour should be given only in settings with continuous cardiac monitoring, such as the intensive care unit. Rates above 20 mEq/ hour are highly irritating to peripheral veins. An infusion rate >40 mEq/hour is not recommended. The preferred vehicle in delivering potassium is saline solution, as infusing large amount of dextrose may stimulate insulin release, which would drive plasma potassium intracellularly. Potassium acetate should be considered in patients with hypokalemia who also have metabolic acidosis or a bicarbonate deficit. Similarly, potassium phosphate can be used in hypokalemic patients with concomitant hypophosphatemia. To maximize potassium retention, serum magnesium concentration should be monitored and deficiency corrected.
Care of Older Adults with Diabetes During Hospitalization
Medha N. Munshi, Lewis A. Lipsitz in Geriatric Diabetes, 2007
In theory, phosphate depletion may contribute to decreased concentrations of 2,3-diphosphoglycerate, leading to a shift of the oxygen dissociation curve to the left and decreasing tissue oxygen delivery. Indeed, phosphate replacement has been shown to increase 2,3-diphophoglycerate during treatment, but no effect has been seen on oxygen availability (27). Since intravenous phosphate replacement has not proven beneficial in several studies (25–27) and may cause symptomatic hypocalcemia and hypomagnesemia (28,29), the degree of phosphate replacement and type of phosphate therapy remains controversial. In general, phosphate replacement is usually reserved for those with severe hypophosphatemia of 1.5 mg/dL or less, normal serum calcium concentration, and normal renal function. The use of small amounts of potassium phosphate intravenously appears to be safe in this setting, with typically 30 to 60 mM potassium phosphate given over 12 to 24 hours. Serum calcium, magnesium, and phosphate levels should all be monitored during phosphate infusion. Oral phosphate replacement remains preferable to intravenous administration and should be implemented as soon as possible.
Parenteral nutrition
Janet M Rennie, Giles S Kendall in A Manual of Neonatal Intensive Care, 2013
Hypophosphataemia often develops in very low birth weight babies receiving PN. If the phosphate remains below 0.8 mmol/L, the only practical solution is to give an infusion of IV phosphate using one of the formulations below (dissolved in 10% dextrose) and to stop the PN for a few hours. Recommendations regarding infusion are a maximum rate of potassium phosphate 0.5 mmol K/kg/h and aim to give about 0.5–1 mmol PO4/kg in 12 hours. Formulas currently available are: potassium phosphate 17.42%, 1 mL contains 2 mmol K and 1 mmol PO4; potassium acid phosphate 13.6%, 1 mL contains 1 mmol PO4 and 1 mmol K; sodium glycerophosphate, 1 mL contains 1 mmol PO4 and 2 mmol Na.
A practical guide to the interpretation of PK/PD profiles of longer-acting analogue insulins. Part one: The principles of glucose clamp studies
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2018
Oppel BW Greeff, Jacob John van Tonder, Kershlin Naidu, Alicia McMaster, Alet van Tonder, Rashem Mothilal
After an overnight fast, a 20% dextrose solution and/or rapid-acting insulin is administered intravenously to reach clamp glucose and insulin target. Insulin is administered to suppress endogenous insulin and hepatic glucose production. Potassium phosphate may also be administered to prevent hypokalaemia.15 Once the clamp target has been reached, infusion of rapid-acting insulin is gradually tapered off and discontinued prior to administration of the long-acting study insulin. The long-acting study insulin is administered at a predetermined dose. Blood samples are collected at regular intervals to determine blood glucose and plasma insulin concentrations. Based on the blood glucose levels determined, the glucose infusion rate is adjusted to maintain clamp target.7,8
An efficient approach for development and optimisation of curcumin-loaded solid lipid nanoparticles’ patch for transdermal delivery
Published in Journal of Microencapsulation, 2021
Fakhara Sabir, Maimoona Qindeel, Asim.ur. Rehman, Nasir Mahmood Ahmad, Gul Majid Khan, Ildiko Csoka, Naveed Ahmed
The drug content in the C-SLNs patch (n = 3, having an area of 2 cm2) was determined in a volumetric flask having a phosphate buffer of pH 7.4. Standard guidelines of USP were used for the preparation of phosphate buffer of pH 7.4. It consists of monobasic potassium phosphate and sodium hydroxide. The strength of both ingredients is about 0.2 M, the measured volume of both solutions i.e. 50 ml of monobasic potassium phosphate and 39.1 ml of sodium hydroxide was taken. Both solutions were then mixed well and the final volume was made up to 200 ml. The patch was placed in the phosphate buffer and the mixture was sonicated for 8–10 h. The solution was filtered through a 0.45 μm membrane filter and samples were analysed. For quantification of drug contents in the C-SLNs loaded patch, spectra at a wavelength of 418 nm were studied using a UV-visible spectrophotometer (Dynamica, HaloDB-20, UK) (Patel et al.2009b).
Investigation of the inhibition of eight major human cytochrome P450 isozymes by a probe substrate cocktail in vitro with emphasis on CYP2E1
Published in Xenobiotica, 2019
Guru R. Valicherla, Amrut Mishra, Srinivas Lenkalapelly, Bhupathi Jillela, Femi M. Francis, Lakshman Rajagopalan, Pratima Srivastava
All incubation mixtures contained microsomal protein 0.2 mg/mL, 1 mM NADPH, 100 mM potassium phosphate buffer (pH 7.4), and individual substrates or probe substrate cocktail (tacrine, diclofenac, S-(+)-mephenytoin, dextromethorphan, midazolam, bupropion, paclitaxel, and chlorzoxazone) in a total volume of 100 µL. Potassium phosphate buffer was prepared fresh weekly by adding 13.98 g of dibasic potassium phosphate and 2.7 g of monobasic potassium phosphate in 1000 mL water and pH adjusted to 7.4. The substrates were used at concentrations equal to their respective Km values: 5 µM for tacrine, diclofenac, paclitaxel, bupropion, dextromethorphan, 2 µM for midazolam, 30 µM for S-(+)-mephenytoin and 200 µM for chlorzoxazone. The final concentrations of methanol, acetonitrile and DMSO for the cocktail incubation conditions were 0.075%, 0.1% and 0.4% respectively. Samples were preincubated for 15 min at 37 °C in shaking water bath (Julabo SW23). The reaction was initiated by the addition of NADPH. Incubation was carried out for 5 min (CYP3A4) and 17 min for remaining isoforms. The reaction was terminated by adding 150 µL ice cold ACN containing internal standard (IS, telmisartan, and metoprolol). Samples were vortexed for 5 min at 900 rpm using Plate Mixer (Mix Mate) and centrifuged for 5 min at 4000 rpm to pellet the precipitated protein. The 150 µL supernatant was transferred to phenomenex plates containing 150 µL water and vortexed for 5 min at 900 rpm. The half diluted samples were analyzed by using LC-MS/MS.
Related Knowledge Centers
- Monopotassium Phosphate
- Phosphate
- Potassium
- Salt
- Dipotassium Phosphate
- Tripotassium Phosphate
- Food Additive
- E Number