Muhammad Amer Mushtaq, Muhammad Masood.
Treatment of hyperkalemia with salbutamol and insulin.
Pak J Med Sci Jan ;22(2):176-9.

Objective: To see the potassium lowering effect of salbutamol and insulin in hyperkalemia, and to compare this hypokalemic effect when these drugs are administered alone or in combination. Place of Study: This interventional study was conducted in Services Hospital Lahore, for a period of one year. Patients and Methods: Fifteen patients with hyperkalemia were divided into three groups. Group A, Band C received 0.5 mg salbutamol diluted in 100 ml 5% water, glucose 25 gm diluted in 100 ml of water plus 10 units of regular insulin and both salbutamol 0.5 mg diluted in 100 ml of water with 25 grams of glucose plus 10 units of regular insulin respectively. Dextrose was given as infusion over 30 minutes and insulin as iv bolus. Blood samples were drawn at 0, 30, 60, 180 and 360 minutes. Blood pressure, pulse, temperature, respiratory rate and ECG were also recorded. Results: Base line serum potassium levels fell from 6.4+0.3mmol/L, 6.5+0.3 mmol/L and 6.5+0.2 mmol /L, to 5.5+0.2 mmol/L, 5.7+0.2mmol/L and 5.4+0.3 mmol /L for groups A, B, and C respectively at 60 minutes. These levels started to creep up again at 180 minutes to 5.7+0.1 mmol /L, 5.9+0.2 mmol /L and 5.5+0.4 mmol /L for groups A, B and C respectively. Conclusion: According to the preliminary report Salbutamol is slightly more effective then insulin in the treatment of hyperkalemia. When administered simultaneously their effect is additive and prolong then administered alone. The number of patients in each group was too small, hence it needs to be studied further.

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