The product is a highly-selective and oral potassium-removing agent already approved for the treatment of adults with
hyperkalaemia. It is an insoluble and non-absorbed sodium zirconium silicate, formulated as a powder for oral suspension.
A 50-year-old woman with refractory
hyperkalaemia was referred to the Renal Unit at Groote Schuur Hospital, Cape Town, SA.
suggested the idea that
hyperkalaemia occurred in these patients because aldosterone could not provide potassium discharge due to a significant decrease in renal tubular sodium.3 However as they stated, the urinary sodium and potassium concentration of the patient they reported (25 and 100 mmol/L, respectively) were not in line with this hypothesis.
ACE-I are well known to be associated with a potential risk of perioperative side effects and complications as intraoperative hypotension and need for vasopressors, preoperative
hyperkalaemia, perioperative druginduced angioedema, and possible postoperative hypertension [1].
Kassem et al., "A case of probable labetalol induced
hyperkalaemia in pre-eclampsia," International Journal of Clinical Pharmacy, vol.
Although intravenous potassium replacement leads to more rapid resolution of symptoms compared to oral replacement, there is an increased risk of potentially fatal rebound
hyperkalaemia, especially at higher doses [1-4].
Devgun, "Coconut water drink and the risk of
hyperkalaemia in diabetes," Practical Diabetes, vol.
Hypokalaemia and
hyperkalaemia. Postgrad Med J 2001; 77: 759-764.
Electrocardiography is unreliable in detecting potentially lethal
hyperkalaemia in haemodialysis patients.
Metabolic conditions (hypokalemia,
hyperkalaemia, hyponatraemia, and hypercalcaemia), medicines with a sodium channel-blocking effect such as class 1 antiarrhythmic drugs, anaesthetics (especially propofol), tricyclic antidepressants, severe fever, or cocaine can cause Brugada phenocopy (1,3-7).
Hb of 9g per DL should be accepted and do not give too much blood quickly which may raise the B.P,
hyperkalaemia and C.C.F