Characteristics K-Dur:
K-Dur The drug is K +, restores water and electrolyte balance. Has a negative chrono-and bathmotropic effect in high doses – a negative foreign-and dromotropic, and mild diuretic effect. In small doses, K + dilates coronary vessels, in large – narrows. Involved in the process of nerve impulses. With / in the introduction increases the release of epinephrine adrenal glands. Activates many cytoplasmic enzymes involved in the maintenance of intracellular osmotic pressure in belkovosinteticheskih reactions and transport of amino acids. Improves the reduction of skeletal muscle in muscular dystrophy, myasthenia gravis. Increasing K + concentration reduces the risk of toxic effects of cardiac glycosides.
Uses K-Dur:
Hypokalemia (including presence of diabetes mellitus, prolonged diarrhea and / or vomiting, therapy, antihypertensive drugs, certain diuretics, corticosteroids), treatment and prevention of digitalis intoxication, prevention of arrhythmias in patients with acute myocardial infarction.
Contraindications K-Dur:
Hyperkalemia, complete AV block, adrenal insufficiency, chronic renal failure, concomitant potassium-sparing diuretics therapy, metabolic disorders (acidosis, hyponatremia with hypovolemia), erosive and ulcerative diseases of the gastrointestinal tract, pregnancy, lactation, age 18 years (effectiveness and safety have not been established).
Side effects K-Dur:
Part of the digestive system: nausea, vomiting, diarrhea, flatulence, abdominal pain, ulceration gastrointestinal mucosa, gastrointestinal bleeding, perforation, and bowel obstruction. Nervous system disorders: paraesthesia, myasthenia gravis, confusion. From the CCC: lowering blood pressure, arrhythmias, heart block, cardiac arrest. Other: hyperkalemia, Allergic reactions. Symptoms: hyperkalemia (muscle gipotonus, paresthesias of extremities, slowing of AV conduction, arrhythmias, cardiac arrest). Early clinical signs of hyperkalemia commonly occur when K + concentration in the serum of more than 6 mEq / L: the sharpening of the T wave, disappearance of the wave U, drop the segment ST, lengthening the interval QT, expansion of the complex QRS. More severe symptoms of hyperkalemia – muscle paralysis and cardiac arrest – are developing at a concentration of K + 9-10 mEq / liter. Treatment: oral or I / O – solution NaCl; I / O – 300-500 ml 5% dextrose (with 10-20 units of insulin per 1 liter), if necessary – hemodialysis and peritoneal dialysis.
Dosage and administration K-Dur:
Inside, the parenteral route. When hypokalemia with cardiac rhythm – at 1-1.5 g 4-5 times a day, after the restoration of heart rate, reduce the dose. If digitalis intoxication – 2-3 g / day, in severe cases – up to 5 g. For cupping of paroxysmal tachycardia in 1 day – 8-12 d, with subsequent reduction in dosage to 3-6 tablets, the retard – 1-2 g / d (up to 6 g / day). V / a bolus, if needed / drip (slowly over 1 hour) – 2-2.5 grams per 500 ml of 5% dextrose. For prevention and treatment of ectopic arrhythmias after myocardial infarction – the polarizing mixture: KCl solution at 5-10% dextrose (added at the rate of insulin 1 IU to 3-4 g dry dextrose).
Cautions K-Dur:
During the period of treatment necessary to control the content of K + in blood serum, ECG, in the treatment of hypokalemia – CBS control. Safety and efficacy of KCl in children have not been established. If necessary, use during pregnancy must be weighed the expected benefits to the mother and the potential risk to the fetus. During the period of lactation should decide on the termination of breastfeeding. A diet with high content of NaCl increases the excretion of K + from the body. Keep in mind that hyperkalemia, resulting in death, can develop rapidly and be asymptomatic.
Interaction K-Dur:
Pharmaceutically compatible with solutions of cardiac glycosides (improves portability). Reinforces the negative Drome and action of antiarrhythmic drugs bathmotropic. As part of a polarizing mixture (in combination with dextrose and insulin) contributes to the normalization of cardiac rhythm in myocardial infarction, arrhythmias and ectopic cardiac glycoside overdose. Eliminates hypokalemia caused by GCS, ISS, and diuretics. Beta-blockers, cyclosporine, potassium-sparing diuretics, heparin, ACE inhibitors, NSAIDs may increase the risk of hyperkalemia. Cementing and overlying drugs reduce the absorption in the gastrointestinal tract.
