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Drugs Affecting the Volume and Ion Content of Body Fluids


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Total plasma osmolality = ?
twice the osmolality of sodium
A red blood cell and plasma have the same osmotic pressure.
If the level of salt in the plasma is too high, the cell collapses.

crenation - water is drawn out of the cell.
If the level of salt in the plasma is too low, the cell swells and ruptures.

hemolysis - water is drawn into the cell.
Isotonic fluids
Normal Saline (NS)
Used to replace body fluids
hypertonic fluids
More concentrated than plasma
Used to draw water from tissue
hypotonic fluids
Less concentrated than plasma
Used to rehydrate tissue
Causes of Hypokalemia
Treatment with loop or thaizide diuretics
Excessive insulin
Vomiting, diarrhea, and laxative abuse
Treatment of Hypokalemia
Potassium salts
Potassium phosphate
Potassium chloride
Potassium bicarbonate
How do you treat Hypokalemia
via IV?
Dilute to 40meq/L
Infuse no faster than 10meq/hr in adults
Monitor renal function
Monitor serum lab values
Causes of Hyperkalemia
Renal disease
Tissue trauma
Treatment of Hyperkalemia
Withhold foods containing potassium
Calcium salt
Glucose and insulin
Sodium bicarbonate
Sodium polystyrene sulfonate (exchange resisn)
Causes of Hypomagnesium
Diarrhea, renal disease, chronic ETOH abuse, pancreatitis
Treatment of Hypomagnesium
Oral - Mag gluconate
IM or IV - Mag sulfate
Treatment of Hypermagnesium
Calcium IV

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