What are the various Potassium binding agents for the management of hyperkalemia
Potassium Binding Agents for the Management of Hyperkalemia
Modified from Chaitman, M., Dixit, D., & Bridgeman, M. B. (2016). Potassium-binding agents for the clinical management of hyperkalemia. P & T, 41 , 43–50.
| SODIUM POLYSTYRENE SULFONATE | PATIROMER | SODIUM ZIRCONIUM CYCLOSILICATE (ZS-9) | |
|---|---|---|---|
| Status | In use for past 60 years | Introduced in 2016 | Approval pending |
| Characteristic | Resin | Resin/polymer | Crystal |
| Mechanism of action and specificity | Exchanges sodium for calcium, magnesium, K + , and ammonium in the colon/rectum | Exchanges calcium for K + , magnesium, and ammonium in the distal colon | Exchanges sodium and hydrogen ions for K + throughout the GI tract; selective for K + and ammonium |
| Dose and routes of administration | Oral: 15 g orally q6h Rectal: 30–50 g q6h | Oral: 8.4–25.2 g/day | Oral: pending FDA approval; 5–10 g/day |
| Onset of action | 1–2 h | 7 h | 1 h |
| Adverse events | Nausea, vomiting, constipation, diarrhea, gastric irritation, colonic necrosis; sodium retention, hypokalemia, hypomagnesemia, hypocalcemia, metabolic alkalosis | Constipation, diarrhea, nausea, vomiting, flatulence; hypokalemia, hypomagnesemia, and possible calcium load. | Constipation, diarrhea, nausea, vomiting; hypokalemia, sodium retention, edema |
FDA , U.S. Food and Drug Administration.
