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Wednesday, April 27, 2011

A Family Doctor's Tale -HYPOKALEMIA

DOC I HAVE HYPOKALEMIA

Hypokalemia is defined as low Potassium in the blood.

Normal blood potassium varies from 3.4 to 5.7 mmol per liter.
Extracellular potassium level represents only 2 per cent of the total body potassium.

Potassium is a major determinent of intracellular volume of cells and intracellur osmolarity.
It is a also an important cofactor in many metabolic processes.
The resting membrane potential and excitable tissues like nerves is mainly determined by ratio of intracellular to extracellular potassium concentrations.

Plasma and extracellular potassium levels are influenced by many factors particularly acid based balance. Acidosis moves potassium out of cells while alkalosis shifts potassium into cells.

Hypokalemia occurs with gastrointestinal or urinary loss especially following use of potassium wasting diuretics or in diabetes mellitus.

Symptoms of hypokalemia:
1.lethargy

2.generalized fatigue

3.muscle weakness

4.polyuria

5.myocardial irritabilty is increased with hypokalemia and the use of digitalis becomes more dangerous.

Diagnosis:
1.Plasma potassium levels

2.Electrocardogram shows flattening of the T waves, U waves and sagging ST segment

Treatment:
1.oral potassium is given in most cases with improvement of blood potassium level

2.Intravenous potassium is given in emergency cases. The concentration of infused potassium should not exceed 40 mEQ per liter except in rare cases.

Prognosis:
is good in most cases depending on rapidity of treatment and cause.

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