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Sodium Zirconium Cyclosilicate
Sodium zirconium cyclosilicate, sold under the brand name Lokelma, is a medication used to treat high blood potassium. Onset of effects occurs in one to six hours. It is taken by mouth. Common side effects include swelling and low blood potassium. Use is likely safe in pregnancy and breastfeeding. It works by binding potassium ions in the gastrointestinal tract which is then lost in the stool. Sodium zirconium cyclosilicate was approved for medical use in the European Union and in the United States in 2018. It was developed by AstraZeneca. Medical use Sodium zirconium cyclosilicate is used to treat high blood potassium. Onset of effects occurs in one to six hours. Mechanism of action ZS-9 is a zirconium silicate. Zirconium silicates have been extensively used in medical applications because of their proven safety. 11 zirconium silicates were screened by an iterative optimization process. ZS-9 selectively captures potassium ions, presumably by mimicking the action ...
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Oral Administration
Oral administration is a route of administration whereby a substance is taken through the Human mouth, mouth, swallowed, and then processed via the digestive system. This is a common route of administration for many medications. Oral administration can be easier and less painful than other routes of administration, such as Injection (medicine), injection. However, the onset of action is relatively low, and the effectiveness is reduced if it is not absorbed properly in the digestive system, or if it is broken down by digestive enzymes before it can reach the bloodstream. Some medications may cause gastrointestinal side effects, such as nausea or vomiting, when taken orally. Oral administration can also only be applied to conscious patients, and patients able to swallow. Terminology ''Per os'' (; ''P.O.'') is an adverbial phrase meaning literally from Latin "through the mouth" or "by mouth". The expression is used in medicine to describe a treatment that is taken orally (but not ...
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Potassium Channels
Potassium channels are the most widely distributed type of ion channel found in virtually all organisms. They form potassium-selective pores that span cell membranes. Potassium channels are found in most cell types and control a wide variety of cell functions. Function Potassium channels function to conduct potassium ions down their electrochemical gradient, doing so both rapidly (up to the diffusion rate of K+ ions in bulk water) and selectively (excluding, most notably, sodium despite the sub-angstrom difference in ionic radius). Biologically, these channels act to set or reset the resting potential in many cells. In excitable cells, such as neurons, the delayed counterflow of potassium ions shapes the action potential. By contributing to the regulation of the cardiac action potential duration in cardiac muscle, malfunction of potassium channels may cause life-threatening arrhythmias. Potassium channels may also be involved in maintaining vascular tone. They also regu ...
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Hyperkalemia
Hyperkalemia is an elevated level of potassium (K+) in the blood. Normal potassium levels are between 3.5 and 5.0 mmol/L (3.5 and 5.0 mEq/L) with levels above 5.5mmol/L defined as hyperkalemia. Typically hyperkalemia does not cause symptoms. Occasionally when severe it can cause palpitations, muscle pain, muscle weakness, or numbness. Hyperkalemia can cause an abnormal heart rhythm which can result in cardiac arrest and death. Common causes of hyperkalemia include kidney failure, hypoaldosteronism, and rhabdomyolysis. A number of medications can also cause high blood potassium including mineralocorticoid receptor antagonists (e.g., spironolactone, eplerenone and finerenone) NSAIDs, potassium-sparing diuretics (e.g., amiloride), angiotensin receptor blockers, and angiotensin converting enzyme inhibitors. The severity is divided into mild (5.5 – 5.9mmol/L), moderate (6.0 – 6.5 mmol/L), and severe (> 6.5mmol/L). High levels can be detected on an electrocardi ...
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Molar Concentration
Molar concentration (also called molarity, amount concentration or substance concentration) is the number of moles of solute per liter of solution. Specifically, It is a measure of the concentration of a chemical species, in particular, of a solute in a solution, in terms of amount of substance per unit volume of solution. In chemistry, the most commonly used unit for molarity is the number of moles per liter, having the unit symbol mol/L or mol/ dm3 (1000 mol/ m3) in SI units. A solution with a concentration of 1 mol/L is said to be 1 molar, commonly designated as 1 M or 1 M. Molarity is often depicted with square brackets around the substance of interest; for example, the molarity of the hydrogen ion is depicted as + Definition Molar concentration or molarity is most commonly expressed in units of moles of solute per litre of solution. For use in broader applications, it is defined as amount of substance of solute per unit volume of solution, or ...
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Heart Arrhythmia
Arrhythmias, also known as cardiac arrhythmias, are irregularities in the cardiac cycle, heartbeat, including when it is too fast or too slow. Essentially, this is anything but normal sinus rhythm. A resting heart rate that is too fast – above 100 beats per minute in adults – is called tachycardia, and a resting heart rate that is too slow – below 60 beats per minute – is called bradycardia. Some types of arrhythmias have no symptoms. Symptoms, when present, may include palpitations or feeling a pause between heartbeats. In more serious cases, there may be presyncope, lightheadedness, Syncope (medicine), passing out, shortness of breath, chest pain, or decreased level of consciousness. While most cases of arrhythmia are not serious, some predispose a person to complications such as stroke or heart failure. Others may result in cardiac arrest, sudden death. Arrhythmias are often categorized into four groups: premature heart beat, extra beats, supraventricular tachycard ...
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Medical Emergency
A medical emergency is an acute injury or illness that poses an immediate risk to a person's life or long-term health, sometimes referred to as a situation risking "life or limb". These emergencies may require assistance from another, qualified person, as some of these emergencies, such as cardiovascular (heart), respiratory, and gastrointestinal cannot be dealt with by the victim themselves.AAOS 10th Edition Orange Book Dependent on the severity of the emergency, and the quality of any treatment given, it may require the involvement of multiple levels of care, from first aiders through emergency medical technicians, paramedics, emergency physicians and anesthesiologists. Any response to an emergency medical situation will depend strongly on the situation, the patient involved, and availability of resources to help them. It will also vary depending on whether the emergency occurs whilst in hospital under medical care, or outside medical care (for instance, in the street or alon ...
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Electrocardiography
Electrocardiography is the process of producing an electrocardiogram (ECG or EKG), a recording of the heart's electrical activity through repeated cardiac cycles. It is an electrogram of the heart which is a graph of voltage versus time of the electrical activity of the heart using electrodes placed on the skin. These electrodes detect the small electrical changes that are a consequence of cardiac muscle depolarization followed by repolarization during each cardiac cycle (heartbeat). Changes in the normal ECG pattern occur in numerous cardiac abnormalities, including: * Cardiac rhythmicity, Cardiac rhythm disturbances, such as atrial fibrillation and ventricular tachycardia; * Inadequate coronary artery blood flow, such as myocardial ischemia and myocardial infarction; * and electrolyte disturbances, such as hypokalemia. Traditionally, "ECG" usually means a 12-lead ECG taken while lying down as discussed below. However, other devices can record the electrical activity of ...
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Angiotensin Converting Enzyme Inhibitors
Angiotensin-converting-enzyme inhibitors (ACE inhibitors) are a class of medication used primarily for the treatment of high blood pressure and heart failure. This class of medicine works by causing relaxation of blood vessels as well as a decrease in blood volume, which leads to lower blood pressure and decreased oxygen demand from the heart. ACE inhibitors inhibit the activity of angiotensin-converting enzyme, an important component of the renin–angiotensin system which converts angiotensin I to angiotensin II, and hydrolyses bradykinin. Therefore, ACE inhibitors decrease the formation of angiotensin II, a vasoconstrictor, and increase the level of bradykinin, a peptide vasodilator. This combination is synergistic in lowering blood pressure. As a result of inhibiting the ACE enzyme in the bradykinin system, the ACE inhibitor drugs allow for increased levels of bradykinin which would normally be degraded. Bradykinin produces prostaglandin. This mechanism can explain ...
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Nonsteroidal Anti-inflammatory Drug
Non-steroidal anti-inflammatory drugs (NSAID) are members of a Indication (medicine), therapeutic drug class which Analgesic, reduces pain, Anti-inflammatory, decreases inflammation, Antipyretic, decreases fever, and Antithrombotic, prevents blood clots. Side effects depend on the specific drug, its dose and duration of use, but largely include an increased risk of Stomach ulcers, gastrointestinal ulcers and bleeds, heart attack, and kidney disease. The term ''non-steroidal'', common from around 1960, distinguishes these drugs from corticosteroids, another class of anti-inflammatory drugs, which during the 1950s had acquired a bad reputation due to overuse and side-effect problems after their introduction in 1948. NSAIDs work by inhibiting the activity of cyclooxygenase enzymes (the COX-1 and COX-2 isozyme, isoenzymes). In cells, these enzymes are involved in the synthesis of key biological mediators, namely prostaglandins, which are involved in inflammation, and thromboxanes, ...
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Spironolactone
Spironolactone, sold under the brand name Aldactone among others, is classed as a diuretic medication. It can be used to treat edema, fluid build-up due to hepatic cirrhosis, liver disease or kidney disease. It is also used to reduce risk of disease progression, hospitalization and death due to some types of heart failure. Other uses include acne and excessive hair growth in women, hypokalemia, low blood potassium that does not improve with Potassium#Supplementation, supplementation, high blood pressure that is difficult to treat and early puberty in boys. It can also be used to block the effects of testosterone in transgender women and Non-binary gender, nonbinary people undergoing Feminizing hormone therapy, feminizing hormone replacement therapy. Spironolactone is usually available in tablets, taken oral administration, by mouth, though topical forms are also available. Common side effects include electrolyte abnormalities, particularly hyperkalemia, high blood potassium ...
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Rhabdomyolysis
Rhabdomyolysis (shortened as rhabdo) is a condition in which damaged skeletal muscle breaks down rapidly. Symptoms may include muscle pains, weakness, vomiting, and confusion. There may be tea-colored urine or an irregular heartbeat. Some of the muscle breakdown products, such as the protein myoglobin, are harmful to the kidneys and can cause acute kidney injury. The muscle damage is most usually caused by a crush injury, strenuous exercise, medications, or a substance use disorder. Other causes include infections, electrical injury, heat stroke, prolonged immobilization, lack of blood flow to a limb, or snake bites as well as intense or prolonged exercise, particularly in hot conditions. Statins (prescription drugs to lower cholesterol) are considered a small risk. Some people have inherited muscle conditions that increase the risk of rhabdomyolysis. The diagnosis is supported by a urine test strip which is positive for "blood" but the urine contains no red blood c ...
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Hypoaldosteronism
Hypoaldosteronism is an endocrinological disorder characterized by decreased levels of the hormone aldosterone. Similarly, isolated hypoaldosteronism is the condition of having lowered aldosterone without corresponding changes in cortisol. (The two hormones are both produced by the adrenals.) Presentation Hypoaldosteronism causes low sodium (hyponatremia), high potassium (hyperkalemia), and metabolic acidosis, a condition in which the body produces excess acid. These conditions are responsible for the symptoms of hypoaldosteronism, which include muscle weakness, nausea, palpitations, irregular heartbeat, and abnormal blood pressure. Causes There are several causes for this condition, including adrenal insufficiency, congenital adrenal hyperplasia, and some medications such as certain diuretics, NSAIDs, and ACE inhibitors. * Primary aldosterone deficiency # Primary adrenal insufficiency # Congenital adrenal hyperplasia ( 21 but not 11β and 17) # Aldosterone synthase deficie ...
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