AI Article Synopsis
- Best practices for managing ileostomies include using immediate release (IR) medications and avoiding enteric coated and prokinetic agents.
- A patient with an ileostomy showed poor response to extended-release (ER) potassium chloride, requiring significantly higher doses to improve potassium levels compared to IR potassium chloride.
- Switching to IR potassium chloride resulted in a much lower dose needed for effective potassium replacement, indicating it may be a better option for patients with altered gastrointestinal tracts.
Article Abstract
Background: Best practices in the management of ileostomies include use of immediate release (IR) medications and elimination of enteric coated and prokinetic agents. Extended-release (ER) potassium chloride is designed for postpyloric release rather than colonic absorption and is postulated to be an appropriate option for potassium repletion in this patient subset.
Case: We present a patient with an ileostomy who received intravenous ER and IR oral potassium chloride supplementation following diverting loop ileostomy. Clinical responsiveness to ER potassium chloride was poor; 15 to 40 mEq was required to replace 0.1 mEq/L of potassium. However, upon transition to IR potassium chloride, only 6.67 mEq was required to replace 0.1 mEq/L of potassium.
Conclusions: Our experience in this case suggests that patients with surgical alterations to their gastrointestinal tracts who fail to have expected rises in serum potassium levels may benefit from early conversion to IR potassium chloride.
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| http://dx.doi.org/10.1097/WON.0000000000000801 | DOI Listing |
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