Management of hypokalaemia

The following general guidance for the management of hypokalaemia may be of particular interest to GPs:

Severity of the hypokalaemia

Serum levels	Mild Higher than 3mmol/L	Moderate asymptomatic 2.6 – 3mmol/L	Severe Less than 2.6mmol/L or symptomatic
Treatment	Potassium effervescent tablets Two tablets twice daily (48mmol) E.g. SandoK ii b.d. or KayCeeL 24mls b.d.	Potassium effervescent tablets Two tablets three times daily (72mmol) E.g. SandoK ii t.d.s. or KayCeeL 24mls t.d.s.	Call medical registrar to arrange iv therapy

Tolerance and compliance issues with potassium effervescent tablets

These are the best absorbed and most reliable preparations for potassium replacement.

Many patients report that they are irritant to the gut and some may decline them on these grounds; this can be improved by the use of an antacid such as Gaviscon.

A proton pump inhibitor such as Omeprazole is also often helpful and this can also reduce the loss of acid from the gut if the patient continues to vomit.  KayCeeL syrup is an alternative that some patients may prefer.