Emergency

Hyperkalemia Emergency Medications

Emergency & Critical Care

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Examples

calcium gluconateregular insulin with dextrosealbuterolsodium bicarbonatesodium zirconium cyclosilicate

Prefix / Suffix: No consistent suffix

Physiology

High potassium disrupts cardiac electrical conduction and can cause fatal arrhythmias. Treatment protects the heart, shifts potassium into cells, and removes potassium from the body.

Mechanism of Action

Calcium stabilizes cardiac membranes. Insulin and albuterol shift potassium intracellularly. Bicarbonate may help in acidosis. Binders or dialysis remove potassium.

Indications

  • Severe hyperkalemia
  • ECG changes from hyperkalemia
  • Hyperkalemia with renal failure
  • Rapid potassium rise or symptoms

Side Effects / Adverse Effects

  • Hypoglycemia after insulin
  • Tachycardia with albuterol
  • Hypercalcemia or tissue injury if calcium extravasates
  • Fluid or sodium load with some therapies
  • GI effects with potassium binders

Contraindications

  • Do not give potassium-containing fluids or supplements
  • Use calcium cautiously with digoxin toxicity per protocol
  • Medication-specific allergy

Nursing Considerations

  • Place patient on cardiac monitor and obtain ECG
  • Give calcium first when ECG changes are present as ordered
  • Check glucose before and after insulin/dextrose therapy
  • Recheck potassium after treatment
  • Prepare for dialysis in severe or refractory cases

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.