Electrolyte disorders

Aminoglycosides
 

Electrolyte disorders can occur with the aminoglycosides and are typically reversible with discontinuation of therapy.

Other potential causes (vomiting and diarrhoea) should be treated if present.

If clinical signs of mild to moderate hypokalaemia develop (i.e. muscle cramps, spasms or weakness) or if serum potassium level is between 2.5-3.4 mmol/litre, potassium replacement is required:
potassium chloride PO a Citation a. 7.5% potassium chloride syrup (1 mmol of K⁺/ml), to be administered using a measuring device (oral syringe, mesuring spoon, or cup with graduations). :
Child under 45 kg: 2 mmol/kg (2 ml/kg) daily in divided doses
Child 45 kg and over and adult: 30 mmol (30 ml) 3 times daily

If clinical signs of severe hypokalaemia develop (i.e. marked muscle weakness, cardiac arrhythmias) or if serum potassium level is < 2.5 mmol/litre, hospitalise and urgently administer potassium chloride by slow IV infusion.

For a patient with hypokalaemia:

• Monitor serum potassium levels and QT interval until they return to normal.
• Consider magnesium PO if serum magnesium cannot be measured. Untreated hypomagnesaemia may lead to "resistance" to correction of hypokalaemia. Magnesium should be taken at least 2 hours before or 4 to 6 hours after the FQs.