Применение:
Применяется при лечении:
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Kalimate A is an ion-exchange resin that is recommended for the treatment of hyperkalaemia associated with anuria or severe oliguria. It is also used to treat hyperkalaemia in patients requiring dialysis and in patients on regular haemodialysis or on prolonged peritoneal dialysis.
Kalimate is indicated for the treatment of hyperkalemia.
Limitation Of Use
Kalimate should not be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action.
Kalimate A is for oral or rectal administration only.
The dosage recommendations detailed in this section are a guide only; the precise requirements should be decided on the basis of regular serum electrolyte determinations.
Adults, including the elderly:
Oral
The usual dose is 15g three or four times a day. Each dose should be given as a suspension in a small amount of water or, for greater palatability, in syrup (but not fruit juices which contain potassium), in the ratio of 3 to 4ml per gram of resin.
Rectal
This route should be reserved for the patient who is vomiting or who has upper gastrointestinal tract problems, including paralytic ileus or it may be used simultaneously with the oral route for more rapid initial results. The resin may be given rectally as a suspension of 30g resin in 150ml of water or 10% dextrose, as a daily retention enema. In the initial stages administration by this route as well as orally may help to achieve a more rapid lowering of the serum potassium level.
The enema should if possible be retained for at least nine hours following which the colon should be irrigated to remove the resin. If both routes are used initially it is probably unnecessary to continue rectal administration once the oral resin has reached the rectum.
Children:
Oral
In smaller children and infants correspondingly smaller doses should be employed by using as a guide a rate of 1mEq of potassium per gram of resin as the basis for calculation. An appropriate initial dose is 1g/kg body weight daily in divided doses, in acute hyperkalaemia. Dosage may be reduced to 0.5g/kg of body weight daily in divided doses for maintenance therapy.
The resin is given orally, preferably with a drink (not a fruit squash because of the high potassium content) or a little jam or honey.
Rectal
When refused by mouth it should be given rectally, using a dose at least as great as that which would have been given orally, diluted in the same ratio as described for adults.
Following retention of the enema, the colon should be irrigated to ensure adequate removal of the resin.
Neonates:
Kalimate A should not be given by the oral route. With rectal administration, the minimum effective dosage within the range 0.5g/kg to 1g/kg should be employed diluted as for adults and with adequate irrigation to ensure recovery of the resin.
General Information
Administer Kalimate at least 3 hours before or 3 hours after other oral medications. Patients with gastroparesis may require a 6 hour separation
Recommended Dosage
The intensity and duration of therapy depend upon the severity and resistance of hyperkalemia.
Oral
The average total daily adult dose of Kalimate is 15 g to 60 g, administered as a 15-g dose (four level teaspoons), one to four times daily.
Rectal
The average adult dose is 30 g to 50 g every six hours.
Preparation And Administration
Prepare suspension fresh and use within 24 hours.
Do not heat Kalimate as it could alter the exchange properties of the resin.
One level teaspoon contains approximately 3.5 g of Kalimate and 15 mEq of sodium.
Oral Suspension
Suspend each dose in a small quantity of water or syrup, approximately 3 to 4 mL of liquid per gram of resin. Administer with patient in an upright position.
Enema
After an initial cleansing enema, insert a soft, large size (French 28) rubber tube into the rectum for a distance of about 20 cm, with the tip well into the sigmoid colon, and tape in place.
Administer as a warm (body temperature) emulsion in 100 mL of aqueous vehicle and flush with 50 to 100 ml of fluid. A somewhat thicker suspension may be used, but do not form a paste.
Agitate the emulsion gently during administration. The resin should be retained for as long as possible and follow by a cleansing enema with a nonsodium containing solution. Ensure an adequate volume of cleansing solution (up to 2 liters) is utilized.
- In patients with plasma potassium levels below 5mmol/litre.
- History of hypersensitivity to polystyrene sulfonate resins.
- Obstructive bowel disease.
- Kalimate A should not be administered orally to neonates and is contraindicated in neonates with reduced gut motility (post-operatively or drug-induced).
Kalimate is contraindicated in patients with the following conditions:
- Hypersensitivity to polystyrene sulfonate resins
- Obstructive bowel disease
- Neonates with reduced gut motility