Podcasts about Hyperkalemia

On this podcast episode, I discuss quinapril pharmacology, adverse effects, drug interactions, pharmacokinetics, and much more. Quinapril is a prodrug that is converted in the liver to its active metabolite, quinaprilat, which inhibits ACE, leading to decreased formation of angiotensin II and reduced aldosterone secretion. Hyperkalemia can occur with quinapril use due to decreased aldosterone, leading to potassium retention—especially in patients with renal impairment. Concomitant use of potassium-sparing diuretics or potassium supplements with quinapril increases the risk of hyperkalemia. NSAIDs may reduce the antihypertensive effect of quinapril and increase the risk of nephrotoxicity, especially in patients with preexisting renal dysfunction.

THE LANCET 2003;362:767-771Background: Angiotensin II which plays a role in ventricular remodeling and progression of heart failure can be produced by pathways independent of angiotensin convening enzyme. Preliminary studies showed that the combination of angiotensin II blockers with angiotensin-converting enzyme inhibitors (ACEi) improves hemodynamics and reduces ventricular remodeling.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.The Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM)-Added trial sough to assess if adding the angiotensin-receptor blocker (ARB), candesartan, to ACEi could improve outcomes in patients with systolic heart failure.Patients: Eligible patients had left ventricular ejection fraction of 40% or less within the previous 6 months, and NYHA class II, III or IV symptoms. Patients with NYHA class II symptoms had to have cardiac-related hospitalization within 6 months. Patients also had to have treatment with ACEi at a constant dose for at least 30 days.Exclusion criteria were not provided in the main manuscript.Baseline characteristics: Patients were recruited from 618 centers in 26 countries. The trial randomized 2,548 patients – 1,276 randomized to receive candesartan and 1,272 to receive placebo.The average age of patients was 64 years and 79% were men. The average left ventricular ejection fraction was 28%. Cardiomyopathy was ischemic in 62% of the patients. The NYHA class was II in 24% of the patients, III in 73% and IV in 3%.Approximately 48% had hypertension, 30% had diabetes, 56% had prior myocardial infarction, 9% had stroke, 27% had atrial fibrillation and 17% were current smokers.At the time of enrollment, 90% were taking a diuretic, 58% were taking digoxin, 55% were taking beta-blockers, 17% were taking spironolactone and all but two patients were taking ACEi.Procedures: The trial was double-blinded. Patients were assigned in a 1:1 ratio to receive candesartan starting at 4 or 8mg once daily or placebo. The treatment was doubled every two weeks to a target dose of 32mg once daily.After randomization, follow up occurred at 2, 4, and 6 weeks, 6 months and every 4 months thereafter.Endpoints: The primary outcome was a composite of cardiovascular death or heart failure hospitalizations. All deaths were classified as cardiovascular unless there was a clear non-cardiac cause.Analysis was performed based on the intention-to-treat principle. The estimated sample size to have 80% power at 5% alpha was 2,300 patients. The sample size calculation assumed 16% relative risk reduction in the primary outcome with candesartan assuming an 18% annual event rate in the placebo arm.Results: The median follow up time was 41 months. The mean candesartan daily dose was 24mg at 6 months.Candesartan reduced the primary endpoint of cardiovascular death or heart failure hospitalizations (37.9% vs 42.3%, adjusted HR: 0.85, 95% CI: 0.75 – 0.96; p= 0.01). Candesartan reduced the individual components of the primary outcome - (23.7% vs 27.3%; p= 0.021) for cardiovascular death and (24.2% vs 28.0%; p= 0.018) for heart failure hospitalizations. There was no significant reduction in all-cause death (29.5% with candesartan vs 32.4%; p= 0.105). The number of patients who had any hospitalization was similar in both groups (66.8% with candesartan vs 67.5%; p= 0.7), however, the total number of hospitalizations was lower with candesartan (2,462 vs 2,798; p= 0.023).Serum creatinine at least doubled in 7% of the patients in the candesartan group vs 6% in the placebo group. In the subset of patients taking spironolactone, serum creatinine at least double in 11% of the patients taking candesartan compared to 4% of the patients taking placebo.Hyperkalemia, defined as serum potassium of 6 mmol/L or higher, occurred in 3% of the patients in the candesartan group vs 1% in the placebo group. In the subset of patients taking spironolactone, hyperkalemia occurred in 4% of the patients taking candesartan compared to 1% of the patients taking placebo.There were two cases of angioedema in the candesartan group and three in the placebo group. All patients were taking an ACEi.There were no significant subgroup interactions, including in patients taking both beta-blockers and ACEi at baseline.Conclusion: In patients with systolic heart failure, adding candesartan to an ACEi reduced the primary composite outcome of cardiovascular death or heart failure hospitalizations with a number needed to treat of approximately of 23 patients over 41 months of follow up. The total number of all-cause hospitalizations was reduced by 336 with candesartan. All-cause death was not significantly reduced with candesartan.While the results of the trial appear impressive, the high number of adverse outcomes with candesartan in patients taking spironolactone is concerning. Spironolactone led to significant reduction in all-cause mortality in patients with systolic heart failure, as seen in the RALES trial, and should be prioritized over adding candesartan. Notably, fewer than 20% of patients in the trial were on spironolactone at baseline; if more had been, the incremental benefit of candesartan would likely have been reduced due to an increased risk of adverse effects from triple neurohormonal blockade (ACEi, ARBs, and mineralocorticoid receptor antagonists). Furthermore, spironolactone acts by blocking the aldosterone receptor, which is downstream in the renin–angiotensin–aldosterone system. Since candesartan blocks angiotensin II upstream in the same pathway, simultaneous inhibition at multiple points may lead to diminishing benefit.Finally, the differences observed in the subgroup of patients on beta-blockers between this trial and Val-HeFT remain unclear and may simply reflect the play of chance. As we previously discussed, patients receiving both an ACEi and beta-blockers had worse outcomes with valsartan in the Val-HeFT trial.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

Heart muscle contraction and repolarization is dependent on Sodium, Calcium, Magnesium, and Potassium ions crossing cellular membranes.When a patient's potassium levels get too low or too high, hypokalemia or hyperkalemia results respectively.Two things that may lead us to suspect hypo or hyperkalemia.Medical conditions & medications that can cause potassium imbalance.ECG changes seen in hypo and hyperkalemia.Critical lab values that would indicate a need for treatment.Emergent, ACLS interventions for hypokalemia and hyperkalemia.Additional information on causes of hypo and hyperkalemia can be found on Ninja Nerd podcast. Check out the pod resources page at passacls.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Heart muscle contraction and repolarization is dependent on Sodium, Calcium, Magnesium, and Potassium ions crossing cellular membranes. When a patient's potassium levels get too low or too high, hypokalemia or hyperkalemia results respectively. Two things that may lead us to suspect hypo or hyperkalemia. Medical conditions & medications that can cause potassium imbalance. ECG changes seen in hypo and hyperkalemia. Critical lab values that would indicate a need for treatment. Emergent, ACLS interventions for hypokalemia and hyperkalemia. Additional information on causes of hypo and hyperkalemia can be found on Ninja Nerd podcast. Check out the pod resources page at passacls.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Safe Meds VIP - Learn about medication safety and download a free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

In this episode, Dr. Valentin Fuster discusses a study on sodium zirconium cyclosilicate (SZC) for managing hyperkalemia in heart failure patients on mineralocorticoid receptor antagonists (MRAs) like spironolactone. While SZC effectively reduced hyperkalemia and allowed higher spironolactone doses, concerns over worsening heart failure events highlight the complex balance between treatment benefits and risks.

They have to have a pulse long enough to FIX the Problem. Link to the full podcast:⁠https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-217-Calcium-for-Hyperkalemia-e2ustm4⁠Thank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

We're told NEVER do CPR in the field, but when would you?Link to full podcast:https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-217-Calcium-for-Hyperkalemia-e2ustm4Thank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

Hopefully, SM titles push you to read the actual research papers.Link to the full podcast:https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-217-Calcium-for-Hyperkalemia-e2ustm4Thank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this episode of the PFC podcast, Dennis and Alex delve into the complexities of scientific article reviews, particularly focusing on a study related to hyperkalemia and its implications in CPR. They discuss the importance of critical thinking in medicine, the gray areas of clinical practice, and the physiological mechanisms behind calcium and sodium bicarbonate use during cardiac arrest. The conversation emphasizes the need for a thorough understanding of research outcomes, limitations, and the application of clinical guidelines in emergency medicine.TakeawaysThe knowledge translation window in medicine is about 17 years.Critical thinking is essential when evaluating medical literature.Medicine often presents gray areas rather than black and white answers.Understanding the physiological mechanisms of treatments is crucial.The outcome of studies should be relevant to clinical practice.Calcium and sodium bicarbonate have specific roles in managing hyperkalemia during CPR.Assessing patients requires more than just looking for classic signs.Confounders in studies can significantly impact outcomes.Clinical practice guidelines provide valuable insights for treatment.Continuous research and questioning are vital for medical advancement.Chapters00:00 Introduction to Scientific Article Review04:14 The Importance of Critical Thinking in Medicine10:41 Understanding Hyperkalemia in CPR11:07 PICO Framework for Research Analysis16:19 Evaluating Study Outcomes and Limitations22:15 Physiological Mechanisms of Calcium and Sodium Bicarbonate28:53 Clinical Practice Guidelines for Hyperkalemia34:07 Conclusions and Future DirectionsThank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

Without an ECG, what can you use to assess for hyperkalemia?Full podcast posting tomorrow.Thank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

Dr. Jordan Cramer joins Dan McCollum to discuss the management of hyperkalemia.   Learn key aspects of the history and physical Discuss the importance of an early ECG. Discover important details about a variety of treatment options.

Listen as Dr. London Smith (.com) and his producer Cameron discuss Hyperkalemia as they share about how you can impress your crush with $20. Not so boring! https://www.patreon.com/join/jockdocpodcast Hosts: London Smith, Cameron Clark. Produced by: Dylan Walker Created by: London Smith

For more information regarding this CME/CE activity and to complete the CME/CE requirements and claim credit for this activity, visit:https://www.mycme.com/courses/managing-the-burden-of-hyperkalemia-9952SummaryIn this concise CME/CE podcast, a cardiologist and a family physician discuss risks associated with hyperkalemia in patients being treated for heart failure or chronic kidney disease (CKD)—including the risks that accompany down-titration or discontinuation of RAASi therapy.Drs. Javed Butler and Neil Skolnik provide guidance on which patients are most at risk and review the use of potassium binders that can manage hyperkalemia without compromising the crucial use of guideline-directed medical therapy (GDMT). By the end of this podcast episode, listeners will feel much more confident in their ability to safely and effectively address hyperkalemia in patients with heart failure or CKD.Learning ObjectivesAt the conclusion of this activity, participants should be better able to:Describe the disparities and clinical implications of hyperkalemia in patients with HF and CKD in terms of optimizing guideline-directed medical therapy (GDMT) and outcomesDiscuss the safety and effectiveness of potassium binders in reducing potassium and optimizing GDMT in patients with HF and CKDThis activity is accredited for CME/CE CreditThe National Association for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.The National Association for Continuing Education designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.The National Association for Continuing Education is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 121222. This activity is approved for 0.25 contact hours (which includes 0 hours of pharmacology).For additional information about the accreditation of this program, please contact NACE at info@naceonline.com.Summary of Individual DisclosuresPlease review faculty and planner disclosures here.Disclosure of Commercial SupportThis educational activity is supported by an educational grant from AstraZeneca Pharmaceuticals.Send us a text about this episode. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.

For more information regarding this CME/CE activity and to complete the CME/CE requirements and claim credit for this activity, visit:https://www.mycme.com/courses/using-newer-agents-in-chronic-hyperkalemia-management-9953SummaryIn this concise CME/CE podcast, a cardiologist and primary care physician review hyperkalemia management options that safely allow continuing GDMT for patients with heart failure or CKD. Using case examples, the clinicians provide education on individualizing treatment and addressing disparities in care.Learning ObjectiveAt the conclusion of this activity, participants should be better able to:Identify practical aspects of using potassium binders for treating hyperkalemia and optimizing GDMT to achieve equitable care for patients with HF and CKDThis activity is accredited for CME/CE CreditThe National Association for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.The National Association for Continuing Education designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.The National Association for Continuing Education is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 121222. This activity is approved for 0.25 contact hours (which includes 0.25 hours of pharmacology).For additional information about the accreditation of this program, please contact NACE at info@naceonline.com.Summary of Individual DisclosuresPlease review faculty and planner disclosures here.Disclosure of Commercial SupportThis educational activity is supported by an educational grant from AstraZeneca Pharmaceuticals.Send us a text about this episode. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.

Heart muscle contraction and repolarization is dependent on Sodium, Calcium, Magnesium, and Potassium ions crossing cellular membranes. When a patient's potassium levels get too low or too high, hypokalemia or hyperkalemia results respectively. Two things that may lead us to suspect hypo or hyperkalemia. Medical conditions & medications that can cause potassium imbalance. ECG changes seen in hypo and hyperkalemia. Critical lab values that would indicate a need for treatment. Emergent, ACLS interventions for hypokalemia and hyperkalemia. Additional information on causes of hypo and hyperkalemia can be found on Ninja Nerd podcast. Check out the pod resources page at passacls.com.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!

CME credits: 0.25 Valid until: 15-01-2026 Claim your CME credit at https://reachmd.com/programs/cme/breaking-the-cycle-addressing-hyperkalemia-in-ckd-and-heart-failure-to-optimize-raasi-therapy/26746/ Patients with CKD or heart failure face the risk of developing hyperkalemia, and healthcare providers often experience clinical inertia in their treatment. Join the experts as they explore chronic hyperkalemia management, and the role of potassium binders. =

Today's sponsor is Freed AI! Freed's AI medical scribe listens, transcribes, and writes notes for you. Over 15,000 healthcare professionals use Freed and you should too! Learn more here! On this episode of the Top 200 Drugs Podcast, I cover medications 146-150. This podcast includes; sevelamer, dalteparin, sertraline, clonazepam, and irbesartan. Sevelamer is a phosphate binder that is used to treat hyperphosphatemia in patients with chronic kidney disease. Dalteparin is a low molecular weight heparin product that is used to prevent and treat blood clots. Sertraline is a commonly used SSRI that can be helpful in managing depression and anxiety. Clonazepam is a benzodiazepine that can be used for acute relief of anxiety. Sedation, confusion, and fall risk are potential adverse effects. Irbesartan is an ARB that can be used for hypertension. Hyperkalemia and angioedema are two adverse effects to be aware of.

Get the show notes for this episode, plus a very neat treatment guide for hyperkalaemia, ⁠here.⁠ Join our community of Vet Vault Nerds to lift your clinical game and get your groove back with our up-to-date, easy-to-consume clinical episodes at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠vvn.supercast.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Get help with your tricky cases in our ⁠⁠⁠⁠⁠⁠⁠⁠Specialist Support Space.⁠⁠⁠⁠⁠⁠⁠⁠ ⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠for Hubert's favourite clinical and non-clinical learnings from the week. You may have heard about a condition where greyhounds can become dangerously hyperkalaemic under anaesthesia, but did you know that this isn't something that happens exclusively in greyhounds? And do you know what the risk factors are for this happening, what you can do to try and prevent it, or how to preempt it? If the answer to any of these is no, and you ever anaesthetise non-human species, then this is one of those “will probably save a patient's life one day” episodes. Our guest is Dr Stacey Jones, who was involved in publishing the first ⁠paper on anaesthesia-associated hyperkalaemia⁠ in greyhounds that brought this condition to the veterinary world's attention. She joins the podcast to share what she learnt while conducting the research for this paper, as well as to provide an update on the work that has been done since that first publication. This update fleshes out our understanding of the condition, focusing on what you need to know about it in practice. Episode Topics and Timestamps 04:06 Symptoms and Detection 07:27 The Greyhound Project: A Case Study 19:15 Hyperkalemia Beyond Greyhounds 22:05 Practical Takeaways 27:53 Conclusion and Additional Resources

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances discusses a recently published original research paper on consequences of recurrent hyperkalemia on cardiovascular outcomes and mortality.

JACC Associate Editor Michelle M. Kittleson, MD, PhD, FACC, interviews author Mikhail Kosiborod, MD, FACC about his REALIZE-K study published in JACC and presented at AHA. In participants with HFrEF and hyperkalemia, SZC led to large improvements in the percentage of participants with normokalemia while on optimal spironolactone dose, and reduced risk of hyperkalemia and down-titration/discontinuation of spironolactone. More participants had HF events with SZC than placebo; this difference was limited to those with very high NTproBNP levels.

Novi Yanti Sari, MD, social media editor of JACC: Heart Failure, discusses a recently published original research paper that explored new ways to manage hyperkalemia in patients with HFrEF.

In this episode of the Top 200 Drugs Podcast, I cover glyburide, citalopram, olmesratan, carvedilol, and tiotropium. Glyburide is a sulfonylurea that is well known to cause hypoglycemia and weight gain because it stimulates the pancreas to increase insulin release. Citalopram is an SSRI most well known for its potential to increase the risk for QTc prolongation. It has a notorious drug interaction with omeprazole Olmesartan is an ARB that can be used for hypertension. Hyperkalemia is an electrolyte imbalance that can be caused by its use. Carvedilol is one of the few beta-blockers with significant alpha-blocking and beta-blocking activity. I discuss what this means in this Top 200 drugs podcast. Tiotropium is an anticholinergic medication that can open the airway. It is most commonly used for COPD.

Heart muscle contraction and repolarization is dependent on Sodium, Calcium, Magnesium, and Potassium ions crossing cellular membranes.When a patient's potassium levels get too low or too high, hypokalemia or hyperkalemia results respectively. Two things that may lead us to suspect hypo or hyperkalemia.Medical conditions & medications that can cause potassium imbalance. ECG changes seen in hypo and hyperkalemia. Critical lab values that would indicate a need for treatment. Emergent, ACLS interventions for hypokalemia and hyperkalemia. Additional information on causes of hypo and hyperkalemia can be found on Ninja Nerd podcast. Check out the pod resources page at passacls.com.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.Good luck with your ACLS class!

CME credits: 0.25 Valid until: 17-10-2025 Claim your CME credit at https://reachmd.com/programs/cme/partnering-for-progress-a-case-study-in-patient-centered-hyperkalemia-management/26749/ Hyperkalemia is a common complication in patients on renin-angiotensin-aldosterone system inhibitor (RAASi) therapy. Join Dr. David Wheeler as he explores strategies for managing hyperkalemia while optimizing treatment benefits. Learn about patient-centered communication techniques, risk factors, and treatment options. Discover the importance of ongoing monitoring and follow-up to ensure optimal management. You don't want to miss this opportunity to improve your clinical practice and enhance patient outcomes. =

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances discusses a recently published original research paper on mortality risk stratification utilizing artificial intelligence electrocardiogram for hyperkalemia in cardiac ICU Patients.

In this episode, Dr. Valentin Foster highlights a groundbreaking study published in the October 2024 issue of JACC, which explores how patiromer facilitates the effective use of angiotensin inhibitors and mineralocorticoid antagonists in heart failure patients at risk of hyperkalemia. Authored by Dr. Bertram Pete and colleagues, the research demonstrates that patiromer not only helps achieve optimal medication doses but also improves potassium management, ultimately enhancing patient outcomes in this high-risk population.

Heart muscle contraction and repolarization is dependent on Sodium, Calcium, Magnesium, and Potassium ions crossing cellular membranes.When a patient's potassium levels get too low or too high, hypokalemia or hyperkalemia results respectively.Two things that may lead us to suspect hypo or hyperkalemia. Medical conditions & medications that can cause potassium imbalance. ECG changes seen in hypo and hyperkalemia. Critical lab values that would indicate a need for treatment.Emergent, ACLS interventions for hypokalemia and hyperkalemia. Additional information on causes of hypo and hyperkalemia can be found on Ninja Nerd podcast. Check out the pod resources page at passacls.com.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.Good luck with your ACLS class!

PART 2. In our last episode, we discussed hyperkalemia management in an otherwise renally healthy patient. But what if your patient has chronic kidney disease? Are they okay if their potassium has been 5.9 for a long time? How does our management change? Nephrologist Dr. Jordan Symons returns to offer his advice on outpatient and inpatient management of acute-on-chronic hyperkalemia.

We've all been there - you're woken up by a critical page and a bright red potassium number blares at you from the computer screen. How do you make sense of the number? What does it mean for a potassium to be hemolyzed? And what are the steps to treating it? Dr. Jordan Symons (Seattle), walks us through all this and more as we learn all about hyperkalemia.

Show notes at pharmacyjoe.com/episode946. In this episode, I'll discuss the effects of calcium during treatment of hyperkalemia. The post 946: Animal data suggest calcium does not stabilize the cardiac membrane in hyperkalemia appeared first on Pharmacy Joe.

Take Home Points Always obtain an EKG in patients with ESRD upon presentation Always obtain an EKG in patients with hyperkalemia as pseudohyperkalemia is the number one cause If the patient with hyperkalemia is unstable or has significant EKG changes (wide QRS, sine wave) rapidly administer calcium salts In patients who are anuric, early mobilization ... Read more The post REBEL Core Cast 125.0 – Hyperkalemia appeared first on REBEL EM - Emergency Medicine Blog.

Roger Seheult, MD of MedCram, describes a situation where a patient nearly had a cardiac arrest. See all Dr. Seheult's videos at: https://www.medcram.com/ (This video was recorded on June 25th, 2024) Roger Seheult, MD is the co-founder and lead professor at https://www.medcram.com He is Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine and an Associate Professor at the University of California, Riverside School of Medicine. MEDCRAM WORKS WITH MEDICAL PROGRAMS AND HOSPITALS: MedCram offers group discounts for students and medical programs, hospitals, and other institutions. Contact us at customers@medcram.com if you are interested. MEDIA CONTACT: Media Contact: customers@medcram.com Media contact info: https://www.medcram.com/pages/media-contact Video Produced by Kyle Allred FOLLOW US ON SOCIAL MEDIA: https://www.facebook.com/MedCram https://twitter.com/MedCramVideos https://www.instagram.com/medcram DISCLAIMER: MedCram medical videos are for medical education and exam preparation, and NOT intended to replace recommendations from your doctor. #hyperkalemia #cardiacarrest #potasium

Sometimes the hardest part is the waiting. When our team is dispatched to a scene where a man who does not speak English is trapped inside a confined space with possible crush injuries, hypothermia and hyperkalemia, they must wait for him to be extricated. How do you stand that interminable time? How do you stay ready? And then how do you switch from inaction to action once it's time? Our team tackles yet another unique case in this month's episode.   Interested in obtaining CE credit for this episode? Visit OnlineAscend.com to learn more. Listeners can purchase individual episode credits or subscribe to the Critical Care Review Bundle and gain access to all episode CE Credits.    We are joined by:     Nissa Hattaway, Flight Nurse BA, BSN, RN, CEN, CPEN, CFRN     Justin Brown, Flight Paramedic NREMT-P Click here to download this episode today! As always thanks for listening and fly safe! Hawnwan Moy MD FACEP FAEMS John Wilmas MD FACEP FAEMS

Heart muscle contraction and repolarization is dependent on Sodium, Calcium, Magnesium, and Potassium ions crossing cellular membranes. When a patient's potassium levels get too low or too high, hypokalemia or hyperkalemia results respectively. Two things that may lead us to suspect hypo or hyperkalemia. Medical conditions & medications that can cause potassium imbalance. ECG changes seen in hypo and hyperkalemia.Critical lab values that would indicate a need for treatment.Emergent, ACLS interventions for hypokalemia and hyperkalemia. Additional information on causes of hypo and hyperkalemia can be found on Ninja Nerd podcast. Check out the pod resources page at passacls.com.Connect with me:Website: https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back - buy Paul a bubble tea hereGood luck with your ACLS class!

Thanks for listening!

Podcast summary of articles from the April 2024 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include co-ventliation, handheld ultrasound for POCUS, naloxone, hyperkalemia, pulmonary embolisms, and multiple sclerosis.  Guest speaker is Dr. Daniel Boyes.

Hyperkalemia is an elevated potassium level that can have serious consequences if left untreated. In this episode, you'll learn: The role of potassium in the body Dangers of hyperkalemia Causes of hyperkalemia What is a hyperkalemic emergency? Treatments for hyperkalemia Hyperkalemia prevention for patients with ESRD ___________________ Full Transcript - Read the article and view references. FREE CLASS - If all you've heard are nursing school horror stories, then you need this class! Join me in this on-demand session where I dispel all those nursing school myths and show you that YES...you can thrive in nursing school without it taking over your life! Study Sesh - Change the way you study with this private podcast that includes dynamic audio formats that help you review and test your recall of important nursing concepts on-the-go. Free yourself from your desk with Study Sesh! Med Surg Solution - Are you looking for a more effective way to learn Med Surg? Enroll in Med Surg Solution and get lessons on 57 key topics and out-of-this-world study guides.  Crucial Concepts Bootcamp - Start nursing school ahead of the game, or reset after a difficult first semester with my nursing school prep course, Crucial Concepts Bootcamp. Learn key foundation concepts, organization and time management, dosage calculations, and so much more. Pharmacology Success Pack - Want to get a head start on pharmacology? Download the FREE Pharmacology Success Pack.

What I Wish I Knew: Potassium-K Lab Value Levels For resources to help you master Potassium and ALL the lab values, we have a FREE Cheatsheet Download at NURSING.com/labvalues.   What do bananas, avocados, and kale all have in common? Potassium! For more resources to help you understand Potassium, Hyperkalemia and Hypokalemia, click here: What role does it play in the body? What's a normal range level for potassium? And what happens when potassium levels are too low or too high? On a shift early in my career, while I was still being oriented to the unit, I held tight to that rule of NEVER pushing IV potassium even when my preceptor was providing instructions that conflicted with that big rule. Here is that story...

What I Wish I Knew: Potassium-K Lab Value Levels For resources to help you master Potassium and ALL the lab values, we have a FREE Cheatsheet Download at NURSING.com/labvalues.   What do bananas, avocados, and kale all have in common? Potassium! For more resources to help you understand Potassium, Hyperkalemia and Hypokalemia, click here: What role does it play in the body? What's a normal range level for potassium? And what happens when potassium levels are too low or too high? On a shift early in my career, while I was still being oriented to the unit, I held tight to that rule of NEVER pushing IV potassium even when my preceptor was providing instructions that conflicted with that big rule. Here is that story...

What I Wish I Knew: Potassium-K Lab Value Levels For resources to help you master Potassium and ALL the lab values, we have a FREE Cheatsheet Download at NURSING.com/labvalues.   What do bananas, avocados, and kale all have in common? Potassium! For more resources to help you understand Potassium, Hyperkalemia and Hypokalemia, click here: What role does it play in the body? What's a normal range level for potassium? And what happens when potassium levels are too low or too high? On a shift early in my career, while I was still being oriented to the unit, I held tight to that rule of NEVER pushing IV potassium even when my preceptor was providing instructions that conflicted with that big rule. Here is that story...

What I Wish I Knew: Potassium-K Lab Value Levels For resources to help you master Potassium and ALL the lab values, we have a FREE Cheatsheet Download at NURSING.com/labvalues.   What do bananas, avocados, and kale all have in common? Potassium! For more resources to help you understand Potassium, Hyperkalemia and Hypokalemia, click here: What role does it play in the body? What's a normal range level for potassium? And what happens when potassium levels are too low or too high? On a shift early in my career, while I was still being oriented to the unit, I held tight to that rule of NEVER pushing IV potassium even when my preceptor was providing instructions that conflicted with that big rule. Here is that story...

HOST: Andy Herber, P.A.-C. GUEST: Mira T. Keddis, M.D. Join our host, Andy J. Herber, P.A.-C., as he explores potassium disorders that are commonly encountered by Primary Care Providers. High and Low potassium if not appropriately managed can lead to lethal complications. This episode provides a discussion about the workup and management of Hyperkalemia and Hypokalemia with Mira T. Keddis, M.D. Mayo Clinic Talks: Lab Medicine Edition | Mayo Clinic School of Continuous Professional Development Connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

Are you familiar with BRASH syndrome? The complex interplay of Bradycardia, Renal Failure, Atrioventricular Block, Shock, and Hyperkalemia forms a collection of clinical signs known as BRASH syndrome. One condition leads to another which leads to another, heightening the severity of symptoms. Fortunately, it's easy to manage if you know what you are treating.In this episode, Sarah Lorenzini breaks down the pathophysiology of BRASH syndrome as she examines a patient case study. Starting with its hallmark features and expanding into the synergistic effects of AV nodal blockers, hyperkalemia and renal failure, she provides insights on recognizing the signs of BRASH syndrome early and the importance of understanding the interplay among its components.Sarah outlines the treatment priorities for BRASH syndrome and highlights the importance of identifying the root cause of symptoms to prevent a cascade of complications leading to shock.Tune in to strengthen your knowledge of BRASH syndrome!Topics discussed in this episode:Case study analysis of a BRASH patientComponents of BRASH SyndromeHow BRASH developed in Sarah's patientTreatment and management of BRASH SyndromeThe role of calcium in treatment of BRASHYou can learn more about BRASH Syndrome at the Internet Book of Critical Care Website:https://emcrit.org/ibcc/brash/Mentioned in this episode:Rapid Response Academy LinkWanna check out Rapid Response Academy: The Heart and Science of Caring for the Sick? click this link to learn more: https://www.rapidresponseandrescue.com/communityRapid Response and Rescue Intro CourseCONNECT

BRASH es un acrónimo relativamente nuevo que describe un síndrome de bradicardias con hipotensión severa en el contexto de fallo renal e hiperkalemia. Usted está atendiendo a un masculino de 62 años de edad con debilidad general y desorientación progresivamente peor desde hace varias horas. Mantiene su propia vía aérea y respira espontáneamente, pero no tiene pulsos periféricos palpables. Los signos vitales son 28, 20, 86%, 82/38. Usted coloca al paciente en el monitor cardiaco y observa un bloqueo AV de 3er grado sin ondas P y con un complejo de escape ventricular. De inmediato le coloca oxígeno al paciente mediante mascarilla de no-reinhalación, obtiene dos accesos vasculares, administra 1 mg de atropina y se prepara para realizar intervenciones de segunda línea para aumentar la frecuencia cardiaca, entre ellas, la administración de una infusión de adrenalina y la colocación de un marcapasos externo. Los algoritmos están hechos para evitar desastres. No necesariamente representan el mejor cuidado posible. En este caso, el algoritmo de bradicardia nos dice qué acciones debemos hacer de inicio para mantener al paciente vivo. Sin embargo, no está funcionando. ¿Por qué? Debido a la hiperkalemia. Los medicamentos que causan bloqueo de la conducción a través del nodo atrioventricular (AV) pueden provocar episodios de hipotensión severa y refractaria en el contexto de fallo renal agudo. Bloqueo AV + fallo renal agudo El fallo renal puede ocurrir por cualquier causa no relacionada. El fallo renal pre-renal puede ocurrir, por ejemplo, por deshidratación severa o cualquier otra causa de pobre perfusión sistémica. El fallo renal produce hiperkalemia. La hiperkalemia y el bloqueo del nodo AV por los bloqueadores beta y/o por los bloqueadores de canales de calcio produce la hipotensión. BRASH: un acrónimo a recordar cuando se trata bradicardias sintomáticas Bradicardia Fallo Renal Bloqueo AV Shock Hiperkalemia Cada una de estas condiciones presenta un problema por sí mismo. Cuando se combinan, tienen un efecto sinergístico. Es decir, tiene un efecto más potente que la suma de sus partes individuales. BRASH no es un diagnóstico por separado, sino una descripción de los signos y síntomas asociados al ciclo vicioso de bradicardia, shock, fallo renal e hiperkalemia. Ciclo vicioso de bradicadia, shock, fallo renal e hiperkalemia La bradicardia puede venir por los medicamentos y/o por la hiperkalemia. En el paciente que ya toma estos medicamentos de forma continua, es posible que un deterioro súbito en la función renal de paso a la hiperkalemia. La causa del deterioro súbito de la función renal puede ser por cualquier causa pre-renal, renal o pos-renal. Una causa común de fallo renal pre-renal es cualquier causa de shock que provoque un episodio sostenido de pobre perfusión renal. El resultado es un aumento en los niveles de potasio debido a la pobre eliminación renal. La hiperkalemia produce bloqueo AV y bradicardia, lo que puede agravar aún más la bradicardia y agravar aún más la pobre perfusión renal, lo que provoca a su vez una peor hiperkalemia. SAMPLE El historial clínico del paciente es fundamental para entender el problema. Signos y síntomas Alergias Medicamentos Padecimientos Última ingesta ("last meal") Evento que precedió la emergencia Pistas importantes del historial El historial puede dar a relucir el hecho de que el paciente esté tomando medicamentos que bloquean el nodo AV. Quizás un cambio reciente en la dosis, o la introducción de otro medicamento que tenga un efecto en los niveles de potasio puede ser el detonante reciente. El historial puede dar a relucir el hecho de que el paciente ya padezca de una condición renal previa. El historial puede dar a relucir algún evento reciente que haya provocado el deterioro agudo en la función renal. Trate la bradicardia, la hiperkalemia y la causa de la pobre perfusión El manejo de la bradicardia puede no ser suficiente para lograr estabilizar hemodinámicamente al paciente con BRASH. Es importante reconocer rápidamente y tratar de inmediato de la hiperkalemia. Aunque las ondas T picudas e hiperagudas son signos clásicos de la hiperkalemia, son signos demasiado tempranos. La evolución natural de la condición va a producir bloqueo AV y prolongamiento del complejo QRS. Es decir, es la propia bradicardia y bloqueo AV el mejor signo de que el paciente puede tener una hiperkalemia. Simultáneo al manejo de la bradicardia y de la hiperkalemia, es esencial tratar la causa que está provocando la pobre perfusión renal (por ejemplo, fallo pre-renal por pobre perfusión). Si esto no se corrige, el escenario va a volver a repetirse. Pequeños estímulos con grandes efectos Como mencionado anteriormente, el efecto de esta combinación es sinergístico. Es decir, el efecto combinado es más grande que la suma de sus efectos individuales. No tiene que haber ocurrido un cambio en la dosis que el paciente está tomando del medicamento que bloquea el nodo AV, ni tiene que ser una dosis especialmente alta. Puede ser la misma dosis que ha tomado por largo tiempo sin efectos adversos. Un episodio reciente de deshidratación no tiene que llevar a fallo renal pre-renal. Sin embargo, en presencia del efecto del medicamento que bloquea el nodo AV, tiene un efecto dramático en el riñón. La hiperkalemia no tiene que ser de inicio muy alta. Es decir, no hay una correlación entre niveles específicos de potasio en sangre y los efectos observados. Peor aún, los cambios en el EKG no necesariamente van a progresar de la misma manera que siempre se habla de la hiperkalemia (primero ondas T hiperagudas). Como mencioné anteriormente, la bradicardia quizás es el único indicio. Entonces, cada uno de los estímulos no tiene que ser muy significativo: una dosis normal del medicamento que siempre ha tomado, un episodio relativamente benigno de deshidratación (por ejemplo), un nivel de potasio levemente elevado... pero la combinación produce una bradicardia severa, con fallo renal, bloqueo AV, shock e hiperkalemia... mejor conocido como BRASH. Referencias Arif AW, Khan MS, Masri A, Mba B, Talha Ayub M, Doukky R. BRASH Syndrome with Hyperkalemia: An Under-Recognized Clinical Condition. Methodist Debakey Cardiovasc J. 2020 Jul-Sep;16(3):241-244. doi: 10.14797/mdcj-16-3-241. PMID: 33133361; PMCID: PMC7587309. Farkas JD, Long B, Koyfman A, Menson K. BRASH Syndrome: Bradycardia, Renal Failure, AV Blockade, Shock, and Hyperkalemia. J Emerg Med. 2020 Aug;59(2):216-223. doi: 10.1016/j.jemermed.2020.05.001. Epub 2020 Jun 18. PMID: 32565167. Lizyness K, Dewald O. BRASH Syndrome. [Updated 2023 Mar 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK570643/ https://emcrit.org/ibcc/brash/ https://litfl.com/brash-syndrome/

Looking for more information on this topic? Check out the Hyperkalemia brick. If you enjoyed this episode, we'd love for you to leave a review on Apple Podcasts.  It helps with our visibility, and the more med students (or future med students) listen to the podcast, the more we can provide to the future physicians of the world. Follow USMLE-Rx at: Facebook: www.facebook.com/usmlerx Blog: www.firstaidteam.com Twitter: https://twitter.com/firstaidteam Twitter: https://twitter.com/mesage_hub Instagram: https://www.instagram.com/firstaidteam/ YouTube: www.youtube.com/USMLERX Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com You will get 5 days of full access to our Rx360+ program, including over 800 Rx Bricks.  After the 5-day period, you will still be able to access over 150 free bricks, including the entire collections for General Microbiology and Cellular and Molecular Biology.

On this episode, I discuss aliskiren pharmacology, adverse effects, drug interactions, and much more. Aliskiren should not be used with ACE Inhibitors or ARBs. I discuss why that is in this episode. Aliskiren has a long enough half-life at approximately 24 hours so it is recommended to only take this once daily. Hyperkalemia is a major concern with aliskiren. It is important to monitor potassium levels and renal function.