PO liquid potassium vs. PO tablet potassium??

[sherlee]

Someone told me the potassium PO tablet form was for maintenance of serum potassium, while the potassium PO liquid form is for repletion. Therefore, if the pt's serum potassium is low, the PO liquid form should be ordered, and not the PO tablet form. Is there any truth to that? I can't find anything about this statement on the internet. Any answers would be much appreciated!

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[smq123]

Someone told me the potassium PO tablet form was for maintenance of serum potassium, while the potassium PO liquid form is for repletion. Therefore, if the pt's serum potassium is low, the PO liquid form should be ordered, and not the PO tablet form. Is there any truth to that? I can't find anything about this statement on the internet. Any answers would be much appreciated!

That's completely news to me. I order K-dur tablets to replete potassium all the time. I've heard that liquid K tastes NASTY, and I imagine that that makes patients less likely to take it.

 

[pinkanml]

Are you sure they were talking "PO" liquid potassium? When someone has a really low K, they'll be given it IV since that will replete them fast. You can also give them K-dur (oral tab), which is a bit slower and can be a good maintenance form.

 

[J ROD]

PO can replenish.....

 

[werd]

that hasn't been the case where i've trained (i did med school and a year of internal medicine residency at an academic center). we mainly used PO K, PO K slow-dissolving, and IV K. there's also a PO liquid but i don't know anything about it being better or having a different side effect profile. the problem with any kind of K is the speed at which you can give it. it causes gi upset PO and vein burning IV.
K replacement will come up daily for you as an intern. since we're on the topic, here are some helpful hints... 1) it takes about 10meq to change K by 0.1 if the K is above 3, and about 20meq to change K by 0.1 if K is below 3... so if someone's K is 3.1, it should take about 40meq of K to get them back to a K of 3.5. if someone's K is 2.8, it will take 40meq to get the K to 3.0 then another 50meq to get them to 3.5, so it will take a total of 90meq total. 2) i personally never give more than 80meq of K before rechecking labs. 3) you can only give 10meq/hour IV through a peripheral line or 20meq/hour IV through a central line; you can only give 40meq of K q4hours PO or else you'll kill their stomach. 4) replete K even if it's just a little low; renal changes from low K will screw up other electrolytes (esp. Mag). cheers 🙂.

 

[Tygacil]

Speaking of mag, gotta replace that first if it's low, it's a cofactor essential for K pumps.

 

[Rendar5]

I've always wanted to use bananas to replete K+. it's like 40meq per banana, iirc. Sadly, I've never had the chance to try this method since we almost never need to replete K+ in the ED since.

 

[J ROD]

Speaking of mag, gotta replace that first if it's low, it's a cofactor essential for K pumps.

qft

 

[J ROD]

I've always wanted to use bananas to replete K+. it's like 40meq per banana, iirc. Sadly, I've never had the chance to try this method since we almost never need to replete K+ in the ED since.

a banana a day keeps teh dr away....

 

[Tygacil]

Actually banana's are about 1meq per inch/ inch and a half🙂

 

[Laryngophed]

Speaking of mag, gotta replace that first if it's low, it's a cofactor essential for K pumps.

qft

That makes sense. ATP "chemistry" is Mg2+ chemistry and nearly all of those K+ pumps require ATP.

Good stuff.

 

[dru2002]

Actually banana's are about 1meq per inch/ inch and a half🙂

You probably went to the same source. http://www.fpnotebook.com/Renal/Pharm/FdsWthHghPtsmCntnt.htm

Unless I did the math wrong these number match up with the source article which is found at the bottom. You should be stocking molasses to feed your patient.

 

[Hernandez]

Why don't you try tasting some liquid k+ and then tell me what you think about that claim.

 

[Tygacil]

Actually I just remembered it from a pharmacy school preceptor. He had gotten in a pseudo argument with a medical resident once who was convinced that bananas had 40+ meqs, until my preceptor explained to him how you could kill yourself off of eating a handful of bananas if that was true.

Dunno how it tastes, but the liquid KCL i've got in my pharmacy is orange flavor. /shrug

 

[J ROD]

Actually banana's are about 1meq per inch/ inch and a half🙂

that's what she said....