Newbie Question

[HelpPleaseMD]

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When you are told that you cannot replete the sodium in a peripheral IV more than 10meq/hr what does that mean? What is a miliequivalent?

 

[Smurfette]

When you are told that you cannot replete the sodium in a peripheral IV more than 10meq/hr what does that mean? What is a miliequivalent?

I think you mean replete POTASSIUM. The dose given is in milliequivalents rather than mg or g like other drugs. The rate at which potassium can be given is typically 10 meq/hr through a peripheral IV or 20 meq/hr via central access. Giving potassium too fast can cause arrhythmias; potassium chloride given in a rapid bolus or IV push format is fatal (it's a medication used in executions).

 

[HelpPleaseMD]

I think you mean replete POTASSIUM. The dose given is in milliequivalents rather than mg or g like other drugs. The rate at which potassium can be given is typically 10 meq/hr through a peripheral IV or 20 meq/hr via central access. Giving potassium too fast can cause arrhythmias; potassium chloride given in a rapid bolus or IV push format is fatal (it's a medication used in executions).

Yep definitely meant potassium. So meq is like grams and is not a concentration?

Will definitely donate after I get home. Sdn has been of so much help over the yrs

 

[Doctor Bob]

What is a miliequivalent?

http://lmgtfy.com/?q=what is a milliequivalent

🤣

 

[neusu]

I think you mean replete POTASSIUM. The dose given is in milliequivalents rather than mg or g like other drugs. The rate at which potassium can be given is typically 10 meq/hr through a peripheral IV or 20 meq/hr via central access. Giving potassium too fast can cause arrhythmias; potassium chloride given in a rapid bolus or IV push format is fatal (it's a medication used in executions).

That being said, you can't replete Na faster than 12 meq/day without risking CPM.

 

[Bacchus]

I think you mean replete POTASSIUM. The dose given is in milliequivalents rather than mg or g like other drugs. The rate at which potassium can be given is typically 10 meq/hr through a peripheral IV or 20 meq/hr via central access. Giving potassium too fast can cause arrhythmias; potassium chloride given in a rapid bolus or IV push format is fatal (it's a medication used in executions).

While we're on this, our pharmacy doesn't let us do more than 40meq through a central line routinely. Are there certain conditions where this is ignored because the repletion is absolutely necessary? Hypokalemia (dangerous levels), I'd assume and my DKA patients I've given some hefty doses (20 in the fluid, 40 in a drip) over an hour. What situations have you run into in your training?

 

[Rendar5]

You shouldn't have to go higher than 40 over an hour. Honestly most conditions that are emergencies related to electrolytes (i.e. arrhythmias and seizures) respond with a modest push towards normal, they don't need to get to normal. 1 dose of Mag will stop eclampsia, 1 quick push of 100 cc 3% saline will stop low sodium seizures without any large increase in overall meq's of sodium. You just need enough to allow the body to recover towards a compensated state. doesn't count towards blockingmedicines of course (sodium/calcium channel blockers) which require enough to overcome.

 

[Dral]

Also, apparently infusing it too quickly is just plain uncomfortable to the pt (burns).

 

[popopopop]

Also, apparently infusing it too quickly is just plain uncomfortable to the pt (burns).

Add Mg to that list too since we're talking about electrolytes.

 

[Bryan O’Blivion]

"It's possible to be in medical school and not know what milliequivalents are?"

You know, it really is possible to forget this. I recently asked a resident this same question, pondering aloud while writing a note. He patiently explained converting Meq to metric weight without a hint of condescension, while my befuddled brain rewound 7 years to a time when I routinely did that sort of thing in Gen Chem class. My face reddened a bit, but out of the murk, I remembered. Happens.

Kudos to the people who salvaged this with a discussion of clinically relevant observations.

 

[evilbooyaa]

It's possible to be in medical school and not know what milliequivalents are?

Yes. I wish people would just use mM instead (especially for univalent ions).

 

[Psai]

It's possible to be in medical school and not know what milliequivalents are?

Why would it not be possible? Seems very reasonable to me.

 

[Anastomoses]

Why would it not be possible? Seems very reasonable to me.

I see that perhaps they aren't used as much as I thought. At my school the biochem lab used meq quite a bit.

 

[ulikedaggers]

I see that perhaps they aren't used as much as I thought. At my school the biochem lab used meq quite a bit.

We never use meq here. I have no idea what it means.

 

[Psai]

I see that perhaps they aren't used as much as I thought. At my school the biochem lab used meq quite a bit.

Chemistry major here with no idea what a meq is either. I looked it up and apparently I learned it as normality, as in molarity multipled by charge.

 

[tco]

Who cares what it means, just don't do it.

I also thought the reason was that it was caustic in high concentrations to peripheral veins, but less so to Central lines.

Then, there's the obvious arrhythmia potential.

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[tco]

Sorry, it seems that this has already been answered. I dislike the app on the phone.

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