What mechanism or mechanisms are used to control a patient\'s electrolyte levels

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Intro Aluminum Hydroxide - AlternaGel ®, Alu-Cap ® Calcium acetate - PhosLo ® Calcitriol - Calcijex ®; Rocaltrol ® Doxercalciferol - Hectorol ® Ferric Sodium Gluconate - Ferrlecit ® paricalcitol - Zemplar ® sevelamer - Renagel ® Intro top of page icon Renal failure/Oliguria (General guidelines) (1) Avoid magnesium containing products (Maalox etc), NSAID’s, and nephrotoxins. (2) Consider fluid challenge to rule out pre-renal azotemia if not fluid overloaded. (3) Lasix: IV bolus 10-200 mg (usually every 2 hours). Doses > 200mg should be infused at 4 to 10 mg/min (usually 4 mg/min) to minimize ototoxicity. IV infusion of 0.25 to 0.4 mg/kg/hour titrated to urine output. (4) Metolazone (Zaroxylyn ® ) 5-10 mg po qd (max 20 mg/day) (5) Bumetanide (Bumex ®): IV bolus 0.5 to 4mg over 1-2min prn (usually q2-3 hr). IV infusion: usually 0.5 to 1 mg/hr. T1/2= 1 to 1.5hr Duration of action: 2-4hrs. (6) Torsemide (Demadex ®): IV bolus: 5 to 100 mg over 1-2 minutes. IV infusion: 5 to 20 mg/hr. [1 mg Bumex] = [10-20 mg Demadex] = [40 mg Lasix] (7) Mannitol: When instituting treatment with mannitol in patients with marked oliguria, a test dose should be used. Infusion of 0.2 grams/kg over 3 to 5 min should produce a diuresis of at least 30 to 50 ml/hr. A second test dose may be given if no response is seen—if no response with second dose—do not use. To treat oliguria: 12.5 to 25 grams IV every 2 to 4 hours. A 15 to 20% solution may be used. Rate should be adjusted to maintain urinary output at 30-50 ml/hr. (Usual test dose= 12.5 grams over 3 to 5 minutes. ) you can use this link for more knowledge. http://www.globalrph.com/renalfx.htm

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