Guidelines for Complications of Cancer Treatment Vol VIII Part B

Table 6 Management of Electrolyte AbnormalitiesAbnormalityHyperphosphatemiaModerate, 2.1 mmol/LSevereManagement RecommendationAvoid IV phosphate administrationAdministration of phosphate binderDialysis, CAVH, CVVH,CAVHD, or CVVHDHypocalcemia, 1.75 mmol/LAsymptomaticNo therapySymptomaticCalcium gluconate 50-100 mg/kgIV administered slowly withECG monitoringHyperkalemiaModerate and asymptomatic, Avoid IV and oral potassium6.0 mmol/L ECG and cardiac rhythm monitoringSodium polystyrene sulphonateSevere (> 7.0 mmol/L) and/or Same as above, plus:symptomaticCalcium gluconate 100-200 mg/kgby slow IV infusion forlife-threatening arrhythmiasRegular insulin (0.1 U/kg IV) +D25 (2 mL/kg) IVSodium bicarbonate(1-2 mEq/kg IV push).However, sodium bicarbonateand calcium should not beadministered through the same line.DialysisRenal dysfunction (uremia) Fluid and electrolyte managementUric acid and phosphate managementAdjust renally excreted drug dosesDialysis (hemo- or peritoneal)Hemofiltration (CAVH, CVVH,CAVHD, or CVVHD)Abbreviations: IV, intravenous; CAVH/CAVHD, continuous arterialvenoushemodialysis; CVVH, continuous veno-venoushemofiltration; CVVHD, continuous veno-venous hemodialysis.435