Figure 321

Treatment of hypokalemia: estimation of potassium deficit. In the absence of stimuli that alter intracellular-extracellular potassium distribution, a decrease in the serum potassium concentration from 3.5 to 3.0 mEq/L corresponds to a 5% reduction (~175 mEq) in total body potassium stores. A decline from 3.0 to 2.0 mEq/L signifies an additional 200 to 400-mEq deficit. Factors such as the rapidity of the fall in serum potassium and the presence or absence of symptoms dictate the aggressiveness of replacement therapy. In general, hypokalemia due to intracellular shifts can be managed by treating the underlying condition (hyperinsulinemia, theophylline intoxication). Hypokalemic periodic paralysis and hypokalemia associated with myocardial infarction (secondary to endogenous ^-adrenergic agonist release) are best managed by potassium supplementation [19].

Treatment of hypokalemia.
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