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Potassium Bicarbonate


General


Pronunciation

(poe TASS ee um bye KAR bun ate)


Brand Names: U.S.

  • K-Bicarb [OTC]

Indications


Use: Labeled Indications

Potassium deficiency, hypokalemia


Contraindications


Hyperkalemia


Dosing and Administration


Dosing: Adult

Hypokalemia: Oral: 25 mEq 2-4 times/day


Dosing: Geriatric

Refer to adult dosing.


Dosing: Pediatric

Hypokalemia: Oral: Children: 1-4 mEq/kg/day


Dosing: Renal Impairment

No dosage adjustment provided in manufacturer 's labeling. However, patients with chronic renal failure require serum potassium monitoring and appropriate dosage adjustment.


Dosing: Hepatic Impairment

No dosage adjustment provided in manufacturer 's labeling.


Storage

Store at room temperature.


Dosage Forms/Strengths


Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Capsule, Oral:

K-Bicarb: 99 mg


Drug Interactions

ACE Inhibitors: Potassium Salts may enhance the hyperkalemic effect of ACE Inhibitors. Monitor therapy

Aliskiren: Potassium Salts may enhance the hyperkalemic effect of Aliskiren. Monitor therapy

Angiotensin II Receptor Blockers: Potassium Salts may enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Monitor therapy

Eplerenone: May enhance the hyperkalemic effect of Potassium Salts. Management: This combination is contraindicated in patients receiving eplerenone for treatment of hypertension. Consider therapy modification

Heparin: May enhance the hyperkalemic effect of Potassium Salts. Monitor therapy

Heparin (Low Molecular Weight): May enhance the hyperkalemic effect of Potassium Salts. Monitor therapy

Nicorandil: May enhance the hyperkalemic effect of Potassium Salts. Monitor therapy

Potassium-Sparing Diuretics: Potassium Salts may enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Consider therapy modification


Monitoring Parameters

Serum potassium, magnesium (to facilitate potassium repletion), and bicarbonate


Warnings/Precautions


Concerns related to adverse effects:

- GI effects: May cause GI upset (eg, nausea, vomiting, diarrhea, abdominal pain, discomfort) and lead to GI ulceration, bleeding, perforation and/or obstruction.

- Hyperkalemia: Close monitoring of serum potassium concentrations is needed to avoid hyperkalemia; severe hyperkalemia may lead to muscle weakness/paralysis and cardiac conduction abnormalities (eg, heart block, ventricular arrhythmias, asystole).

Disease-related concerns:

- Acid/base disorders: Use with caution in patients with acid/base alterations; changes in serum potassium concentrations can occur during acid/base correction, monitor closely.

- Cardiovascular disease: Use with caution in patients with cardiovascular disease (eg, heart failure, cardiac arrhythmias); patients may be more susceptible to life-threatening cardiac effects associated with hyper/hypokalemia.

- Potassium-altering conditions/disorders: Use with caution in patients with disorders or conditions likely to contribute to altered serum potassium and hyperkalemia (eg, untreated Addisons disease, heat cramps, severe tissue breakdown from trauma or burns).

- Renal impairment: Use with caution in patients with renal impairment; monitor serum potassium concentrations closely with severe impairment.

Concurrent drug therapy issues:

- Digitalis: Use with caution in digitalized patients; may be more susceptible to potentially life-threatening cardiac effects with rapid changes in serum potassium concentrations.

- Potassium-altering therapies: Use with caution in patients receiving concomitant medications or therapies that increase potassium (eg, ACEI, potassium-sparing diuretics, potassium containing salt substitutes).


Pregnancy Risk Factor

C


Pregnancy Considerations

Animal reproduction studies have not been conducted. Potassium requirements are the same in pregnant and nonpregnant women. Adverse events have not been observed following use of potassium supplements in healthy women with normal pregnancies. Use caution in pregnant women with other medical conditions (eg, pre-eclampsia; may be more likely to develop hyperkalemia) (IOM, 2004).


Patient and Family Education


Patient Education

- Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

- Patient may experience diarrhea. Have patient report immediately to prescriber signs of hyperkalemia, severe nausea, abdominal edema, melena, hematemesis, or considerable dyspepsia (HCAHPS).

- Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.

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