Low Potassium (Hypokalemia) (cont.)
What is the treatment for low potassium?
Serum potassium levels above 3.0 mEq/liter are not considered dangerous or of
great concern; they can be treated with potassium replacement by mouth. Levels
lower than 3.0 mEq/liter may require intravenous replacement. Decisions are
patient-specific and depend upon the diagnosis, the circumstances of the
illness, and the patient's ability to tolerate fluid and medication by mouth.
Over the short term, with self-limited illnesses like gastroenteritis with
vomiting and diarrhea, the body is able to regulate and restore potassium levels
on its own. However, if the hypokalemia is severe, or the losses of potassium
are predicted to be ongoing, potassium replacement or supplementation may be
required.
In those patients taking diuretics, often a small amount of oral potassium
may be prescribed since the loss will continue as long as the medication is
prescribed. Oral supplements may be in pill or liquid form, and the dosages are
measured in mEq. Common doses are 10-20mEq per day. Alternatively, consumption
of foods high in potassium may be suggested for replacement. Bananas, apricots,
oranges, and tomatoes are high in potassium content. Since potassium is excreted
in the kidney, blood tests that monitor kidney function may be ordered to
predict and prevent potassium levels from rising too high.
When potassium needs to be given intravenously, it must be given slowly.
Potassium is irritating to the vein and must be given at a rate of approximately
10 mEq per hour. As well, infusing potassium too quickly can cause heart
irritation and promote potentially dangerous rhythms like ventricular
tachycardia.
A Special Situation: Periodic Paralysis
Rarely, a special situation will occur when all the potassium in the body
shifts from the serum into the cells of the body. This drops the serum potassium
levels to 1.0 mEq/liter or lower. This causes immediate muscle weakness to the
point that the patient cannot move. Arms and legs are most affected. Rarely,
breathing and swallowing muscles can be involved.
Periodic paralysis may be hereditary and may be precipitated by excessive
exercise, a high carbohydrate or high salt meal, or may occur without apparent
cause.
Treatment by potassium replacement intravenously is effective, and recovery
occurs within 24 hours.
Next: How can low potassium be prevented? »
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