Hypokalemia

• Facts:
  Serum potassium < 3.6 mEq/L
  Severe hypokalemia < 2.5 mEq/L
• History / PE:
  Muscle weakness/cramps
  Ileus
  Hyporeflexia
  Tetany
  Fatigue
  Ascending paralysis
• Diagnosis:
  T wave flattening, U Waves, and ST segment depression
• Treatment:
  IV potassium (do not exceed 20mEq/L/hr)
  Replace magnesium
  Monitor EKG
• Complications:
  Atrial fibrillation
  Torsades de pointes
  Ventricular fibrillation
• Notes:
  Hypokalemia sensitizes heart to digoxin
  
  Hypomagnesemia causes refractory hypokalemia, therefore must correct magnesium along with potassium
• Associated With:
  Potassium wasting diuretic (eg. Thiazide diuretics )
  Nausea/ vomiting
  Hyperaldosteronism
  Asthmatics (use of beta adrenergic drugs that drive potassium back into cells)