used to correct metabolic acidosis *sodium overload, renal calculi & metabolic alkalosis (blood acidity) - interacts with steroids promotes potassium secretion and sodium absorption - used to treat hyperkalemia *sodium retention, hypocalcemia, hypokalemia - used very carefully in heart patients, edema & HTN can be given PO/PR - mix with juice if given orally retain enema for 30-60 minutes after administration irrigate the colon with non-sodium containing fluid after the solution is expelled used to treat hypokalemia in patients on diuretics, with potassium loss due to NVD, abuse of laxatives & those with GI problems *NVD, abdominal discomfort, ulceration, hyperkalemia - watch closely with ACE inhibitors Oral - mix powder in 4 oz of liquid IV - never give undiluted potassium via IV, it can cause fatal hyperkalemia

1. Sodium Bicarb

used to correct metabolic acidosis

*sodium overload, renal calculi & metabolic alkalosis (blood acidity) - interacts with steroids

2. Kayexalate

promotes potassium secretion and sodium absorption - used to treat hyperkalemia

*sodium retention, hypocalcemia, hypokalemia - used very carefully in heart patients, edema & HTN

3. Kayexalate administration

can be given PO/PR - mix with juice if given orally

retain enema for 30-60 minutes after administration

irrigate the colon with non-sodium containing fluid after the solution is expelled

4. Potassium supplements

used to treat hypokalemia in patients on diuretics, with potassium loss due to NVD, abuse of laxatives & those with GI problems

*NVD, abdominal discomfort, ulceration, hyperkalemia - watch closely with ACE inhibitors

5. Potassium supplement administration

Oral - mix powder in 4 oz of liquid

IV - never give undiluted potassium via IV, it can cause fatal hyperkalemia. No more than 40mEq/L, no faster than 10mEq/hr

*potassium burns the vein

6. Magnesium sulfate

used for people with hypomagnesium, to prevent low magnesium levels - normal is 1.3-2.1

*respiratory depression, cardiac depression, neuromuscular blockade, diarrhea & use cautiously in patients with cardiac or renal disease

7. Mag toxicity

depressed or absent deep tendon reflex

*Calcium gluconate is the antidote

8. Calcium supplements

used with caution in people who are pregnant, lactating, have decreased GI function, kidney disease or are dehydration

*interact with glucocorticoids, tetrcycline & thyroid hormone - reduces their absorption; increased risk of hypercalcemia with thiazide diuretics

9. SERMs

used to treat post-menopausal osteoporosis & for protection against breast cancer

increased risk of PE & DVT, need to discourage long periods of inactivity & stop prior to surgery

*causes hot flashes and is not for pregnant women or those with a history or DVT & PE

10. Bisphosphonates

used to treat/prevent post-menopausal osteoporosis

*esophagitis, must be able to stand for 30 minutes after administration