18G
Paramedic
- 1,368
- 12
- 38
I was doing some overdue research today on hyperkalemia and learned a lot of information on the effects of albuterol in lowering potassium concentration. I found it very interesting that a medication commonly used to treat respiratory illnesses was very effective in treating an electrolyte disorder. I've only recently started hearing of albuterol being used for this so I assume the research is fairly new? I noticed in the draft DC EMS protocols, albuterol is an indicated treatment for hyperkalemia.
In case some aren't aware of how albuterol works in hyperkalemia I'll share an overview of what I was able to gather today... (others please correct if I give any misinformation and please share additional information on the topic).
The mechanism for which albuterol works in lowering potassium concentration is it stimulates release of glucose which in turn elevates the insulin level thus driving the potassium into the cells. Increased insulin activity also stimulates the Na/K+ pump also causing an increase in the driving of potassium into the cells.
One research study cited albuterol as having the same efficacy as insulin + glucose. The combined treatments have an even greater effect in lowering potassium level. No significant effects were noted with the high doses of albuterol administered. Albuterol was noted as causing a decrease in potassium by almost one mEq (0.63-0.98mEq) which is about the same as insulin + glucose administration.
The dose of albuterol for treating hyperkalemia is 10-20mg.
One question I have is will albuterol work in lowering potassium concentration in Type I diabetics? If the patient cannot increase insulin levels in response to the increased glucose level caused by the albuterol, how will the potassium be driven into the cells and the Na/K+ pump be stimulated? I tried researching this but came up empty.
I look forward to hearing comments and feedback.
In case some aren't aware of how albuterol works in hyperkalemia I'll share an overview of what I was able to gather today... (others please correct if I give any misinformation and please share additional information on the topic).
The mechanism for which albuterol works in lowering potassium concentration is it stimulates release of glucose which in turn elevates the insulin level thus driving the potassium into the cells. Increased insulin activity also stimulates the Na/K+ pump also causing an increase in the driving of potassium into the cells.
One research study cited albuterol as having the same efficacy as insulin + glucose. The combined treatments have an even greater effect in lowering potassium level. No significant effects were noted with the high doses of albuterol administered. Albuterol was noted as causing a decrease in potassium by almost one mEq (0.63-0.98mEq) which is about the same as insulin + glucose administration.
The dose of albuterol for treating hyperkalemia is 10-20mg.
One question I have is will albuterol work in lowering potassium concentration in Type I diabetics? If the patient cannot increase insulin levels in response to the increased glucose level caused by the albuterol, how will the potassium be driven into the cells and the Na/K+ pump be stimulated? I tried researching this but came up empty.
I look forward to hearing comments and feedback.