Agent | Dose | Onset of action |
Stabilization of cardiac myocardial membrane in setting of hyperkalemia-associated abnormal ECG or arrhythmia* | ||
Calcium gluconate, 10 percent¶ | 0.5 to 1 mL/kg IV over 5 to 15 min (50 to 100 mg/kg calcium gluconate, maxiumum dose 3 grams) Repeat after 10 minutes, if needed | Immediate |
Movement of extracellular potassium into the cells* | ||
Glucose and insulin | IV administration of glucose 0.5 g/kg (equal to 2 mL/kg of a 25 percent dextrose solution) IV administration of insulin 0.1 units/kg over 30 min | 30 minutes |
Inhaled beta-agonists (albuterol) | 0.1 to 0.3 mg/kg | 30 minutes |
Sodium bicarbonateΔ | IV administration of 1 mEq/kg over 10 min (maximum dose of 50 mEq per hour) | 15 minutes |
Removal of potassium | ||
Sodium polystyrene sulfonate | 1 g/kg PO or PR with sorbitol | 1 to 2 hours |
Furosemide | IV administration of 1 to 2 mg/kg with replacement of fluid loss | 1 to 2 hours |
Hemodialysis |
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