|
Pronunciation |
|
(SOW
dee um pol ee STYE reen SUL fon
ate) |
|
|
U.S. Brand
Names |
|
Kayexalate®; SPS® |
|
|
Generic
Available |
|
Yes |
|
|
Pharmacological Index |
|
Antidote |
|
|
Use |
|
Treatment of hyperkalemia |
|
|
Pregnancy Risk
Factor |
|
C |
|
|
Contraindications |
|
Hypernatremia, hypersensitivity to any component |
|
|
Warnings/Precautions |
|
Use with caution in patients with severe congestive heart failure,
hypertension, edema, or renal failure; avoid using the commercially available
liquid product in neonates due to the preservative content; large oral doses may
cause fecal impaction (especially in elderly); enema will reduce the serum
potassium faster than oral administration, but the oral route will result in a
greater reduction over several hours. |
|
|
Adverse
Reactions |
|
1% to 10%:
Gastrointestinal: Fecal impaction, constipation, loss of appetite, nausea,
vomiting |
|
|
Overdosage/Toxicology |
|
Symptoms of overdose include hypokalemia including cardiac dysrhythmias,
confusion, irritability, EKG changes, muscle weakness, gastrointestinal effects
Treatment is supportive, limited to management of fluid and electrolytes
|
|
|
Drug
Interactions |
|
Systemic alkalosis and seizure has occurred after cation-exchange resins were
administered with nonabsorbable cation-donating antacids and laxatives (eg,
magnesium hydroxide, aluminum carbonate) |
|
|
Stability |
|
Store prepared suspensions at 15°C to
30°C (59°F to
86°F); store repackaged product in refrigerator and use
within 14 days; freshly prepared suspensions should be used within 24 hours; do
not heat resin suspension |
|
|
Mechanism of
Action |
|
Removes potassium by exchanging sodium ions for potassium ions in the
intestine before the resin is passed from the body; exchange capacity is 1 mEq/g
in vivo, and in vitro capacity is 3.1 mEq/g, therefore, a wide
range of exchange capacity exists such that close monitoring of serum
electrolytes is necessary |
|
|
Pharmacodynamics/Kinetics |
|
Onset of action: Within 2-24 hours
Absorption: Remains in GI tract
Elimination: Completely in feces (primarily as potassium polystyrene
sulfonate) |
|
|
Usual Dosage |
|
Children:
Oral: 1 g/kg/dose every 6 hours
Rectal: 1 g/kg/dose every 2-6 hours (In small children and infants, employ
lower doses by using the practical exchange ratio of 1 mEq K+/g of
resin as the basis for calculation)
Adults:
Oral: 15 g (60 mL) 1-4 times/day
Rectal: 30-50 g every 6 hours |
|
|
Dietary
Considerations |
|
Do not mix in orange juice |
|
|
Monitoring
Parameters |
|
Serum electrolytes (potassium, sodium, calcium, magnesium),
EKG |
|
|
Reference Range |
|
Serum potassium: Adults: 3.5-5.2 mEq/L |
|
|
Patient
Information |
|
Emergency instructions depend on patient's condition. You will be monitored
for effects of this medication and frequent blood tests may be necessary. Oral:
Take as directed. Mix well with a full glass of liquid (not orange juice). You
may experience nausea or vomiting (small frequent meals, frequent mouth care,
chewing gum, or sucking lozenges may help); or constipation or fecal impaction
(increased dietary fluids and exercise may help). Report persistent constipation
or gastrointestinal distress; chest pain or rapid heartbeat; or mental confusion
or muscle weakness. Pregnancy/breast-feeding precautions: Inform
prescriber if pregnant. Consult prescriber if
breast-feeding. |
|
|
Nursing
Implications |
|
Administer oral (or NG) as ~25% sorbitol solution, never mix in orange juice;
enema route is less effective than oral administration; retain enema in colon
for at least 30-60 minutes and for several hours, if possible; chilling the oral
mixture will increase palatability; enema should be followed by irrigation with
normal saline to prevent necrosis |
|
|
Dosage Forms |
|
Oral or rectal:
Suspension: 1.25 g/5 mL with sorbitol 33% and alcohol 0.3% (60 mL, 120 mL,
200 mL, 500 mL) |
|
|
References |
|
Belanger DR, Tierney MG, and Dickinson G,
"Effect of Sodium Polystyrene Sulfonate on Lithium Bioavailability," Ann
Emerg Med, 1992, 21(11):1312-5.
Haupt HM and Hutchins GM, "Sodium Polystyrene Sulfonate Pneumonitis," Arch
Intern Med, 1982, 142(2):379-81.
Malone TA,
"Glucose and Insulin Versus Cation-Exchange Resin for the Treatment of Hyperkalemia in Very Low Birth Weight Infants,"
J Pediatr, 1991, 118(1):121-3.
Tomaszewski C, Musso C, Pearson JR, et al,
"Lithium Absorption Prevented by Sodium Polystyrene Sulfonate in Volunteers,"
Ann Emerg Med, 1992, 21(11):1308-11.
|
|
Copyright © 1978-2000 Lexi-Comp Inc. All Rights Reserved
|