Potassium

Potassium is a natural essential mineral belonging to the supplement class.

Potassium is also known as K, potash and kalium.

The most prevalent intracellular cation is Potassium, a vital macromineral and electrolyte required for maintaining the balance of blood pH, neuron innervation, muscle contraction, and water balance.

Potassium deficiency leads to hypokalemia (serum potassium level less than 3.6 mmol/L). It is characterized by increased blood pressure, kidney stone risk, bone turnover, urinary calcium excretion, and salt sensitivity.

Several foods are high in Potassium, such as fruits and vegetables (apricots, bananas), legumes (lentils, beans), dairy (yoghurt), fish, poultry, and meats.

Potassium is absorbed in the small intestine after ingestion, carried through the circulation, utilized by cells for several physiological functions, and mostly eliminated through urine, maintaining electrolyte balance and biological processes.

The common side effects of Potassium include nausea, vomiting, diarrhoea and intestinal gas.

Potassium is available in tablets, capsules, solutions and premix packets.

Biochemical action of Potassium

Potassium belonging to the supplement class helps in several physiological processes. Potassium acts to preserve acid-base balance and maintain isotonicity and electrodynamic cellular function.

Potassium maintains the passive membrane potential, which is necessary for the movement of nerve impulses and the contraction of muscles at the cellular level. In addition, Potassium influences cellular metabolism and energy generation by serving as a cofactor for several enzymes. Their role influences enzyme activity and protein structure in intracellular pH regulation. The osmotic balance of Potassium between intracellular and external fluids is essential for preserving cell volume and overall fluid balance. Additionally, it promotes cellular development and energy storage by assisting in protein synthesis and glycogen production. Potassium also affects how glucose is used, increasing insulin production and cellular glucose absorption. Healthy potassium levels can counteract sodium's tendency to raise blood pressure, improving cardiovascular health. Sodium reabsorption and water balance are both affected by Potassium's renal function, showing the element's complex biochemical effects.

Elemental Potassium is never found by itself. Instead, it is usually found in combination with another substance. The most typical potassium component is potassium chloride.

Potassium is available in tablets, capsules, solutions and premix packets.

• Tablets: To be swallowed whole with water/liquid, as applicable.
• Capsules: To be swallowed whole with water/liquid, as applicable.
• Solutions, oral: To be taken with water or other liquid, as applicable.
• Premix packet, oral: Powders must be mixed thoroughly with the appropriate amount of liquid and stirred well to dissolve the powder, as applicable.

Potassium can be used as a supplement when the amount of Potassium taken from the diet is insufficient.

Potassium supplements may be used to prevent and treat hypokalemia, a condition in which the body needs Potassium.

A potassium supplement is useful in carbohydrate metabolism, converting glucose into glycogen for energy storage.

When taken as a supplement, Potassium helps reduce blood pressure, especially in people with high blood pressure, low Potassium, and high salt levels. It can be lowered by 4-5 mmHg with a daily intake of 3500-5000 mg.

Vitamins and natural supplements should not replace a balanced diet.

This product is not intended to diagnose, treat or prevent any disease(s).

Potassium may be useful as a supplement for the following health benefits:

• High blood pressure and stroke- Major risk factors for stroke and coronary heart disease include high blood pressure. Low potassium intakes increase the risk of developing high blood pressure in people, mainly if their diets are rich in salt (sodium). Your blood pressure may be lowered, and your risk of stroke decreased by increasing the Potassium and reducing the sodium in your diet.
• Kidney stones- Too little Potassium can cause the bones to deplete calcium and cause more calcium to be expelled in the urine. The kidneys may develop hard deposits (stones) from this calcium, which can be painful. Intake of more Potassium can lower the risk of getting kidney stones.
• Bone health- One study found that those who consume a lot of Potassium from fruits and vegetables have stronger bones. Eating more rich-potassium foods might improve your bone health by raising bone mineral density, which is a gauge of bone strength.
• Blood sugar control and type 2 diabetes- Blood sugar levels may rise due to low potassium intake. In the long term, this may increase the risk of type 2 diabetes and insulin resistance. Further investigation is needed to fully understand the effects of potassium consumption on blood sugar levels and the risk of type 2 diabetes.
• Fluid Retention- Encouraging sodium excretion may help reduce water retention and bloating.
• Nerve Transmission- The transmission of nerve impulses, which enables communication between nerve cells, depends on Potassium.
• Muscle Function- Potassium is essential for maintaining a regular heartbeat and for the contraction of all muscles, including those of the heart.

Potassium supplementation may be administered orally.

Potassium supplements are available in tablets, capsules, solutions and premix packets that can be taken orally. It is best taken with a meal or within 30 minutes after meals. Taking potassium supplements in the morning is recommended so the body can use them throughout the day for its various functions.

The dosage and duration of treatment should be as per the clinical judgment of the treating healthcare professional).

Vitamins and natural supplements should not replace a balanced diet

This product is not intended to diagnose, treat or prevent any disease(s).

Tablet: 20mEq

Tablet, extended-release: 8mEq, 10mEq, 15mEq, 20mEq

Solution, oral: 20mEq/15mL, 40mEq/15mL, 20mEq

Capsules, extended-release: 8mEq, 10mEq

Premix Packet, oral: IV in plastic container: 10mEq, 20mEq, 30mEq, 40mEq

Dosage Adjustment for Adult Patients

Hypokalemia

Mild to moderate

Capsules or tablets: 40-100 mEqorally qDay in divided doses. To minimize GI discomfort a single dose should not exceed 25 mEq

Oral solution: 40 to 100 mEq orally qDay in 2 to 5 divided doses but limit a single doses to 40 mEq/dose; not to exceed 200 mEq/24hr

Alternatively, 10 to 20 mEq orally BID/QID (20-80 mEq/day)

Severe hypokalemia

40 mEq PO TID/QID; may also administer 20 mEq PO BID/TID in addition to IV potassium administration with careful monitoring; doses >40 mEq are typically not well tolerated orally, resulting in GI irritation and nausea

Hypokalemia Prophylaxis

20-40 mEq PO qDay or divided BID

Potassium is available in tablets, capsules, solutions and premix packets.

Potassium should be used as a supplement that helps in several physiological processes and appropriate dietary restrictions.

• Avoid alcoholic beverages.
• Stay within your daily calorie needs.
• Limit foods and beverages higher in added sodium, sugars, saturated fat and Potassium.
• Avoid high-Potassium foods.

The dietary restriction should be individualized as per patient requirements.

Recommended Daily Allowance (RDA):

The RDA set for males is 3,400 mg, and for females is 2,600 mg.

Upper Tolerable Intake (UTL):

The UTL is not well established.

Potassium supplementation may be contraindicated in the following conditions:

• Hypersensitivity: sensitive to Potassium
• Inadequate or absent urine output
• Chronic kidney disease
• GI mobility disorders
• Hepatic impairment
• Hyperkalemia
• Systemic acidosis which is caused by diabetes, acute dehydration, serious destruction of tissue from severe burns, and adrenal insufficiency

Potassium supplements should be used cautiously in liver/biliary tract dysfunction.

In patients with delayed gastrointestinal transit brought on by structural or functional issues, potassium supplements taken orally should be administered with caution.

Patients who use ACE inhibitors or potassium-sparing drugs, which are commonly used to treat high blood pressure, as well as people with impaired renal function.

Avoid using salt replacements, eating low-sodium meals, particularly some bread and canned goods, and drinking low-sodium milk, as these items may contain Potassium.

Caution is advised when consuming alcohol with Potassium.

Safe to use during breastfeeding when used within RDA limits.

Safe to use during pregnancy when used within RDA limits.

Limit the consumption of foods and beverages higher in added sugars, saturated fat, and Potassium alcoholic drinks, as this substance could hinder potassium absorption.

The adverse reactions related to Potassium can be categorized as-

• Common: Hyperkalemia (muscle weakness, tingling sensations, and irregular heartbeats) and GI disturbances (nausea, vomiting, and diarrhoea)
• Less Common: Hypokalemia (muscle cramps, fatigue, and abnormal heart rhythms) and renal impairment.
• Rare: Cardiac arrhythmias, intestinal blockage and death.

The clinically relevant drug interactions of potassium are briefly summarized here:

• ACE inhibitors: Potassium levels might rise after taking some blood pressure drugs. The body may become too potassium-concentrated if potassium supplements are used simultaneously with some blood pressure drugs. However, the levels of Potassium do not appear to rise when taking these drugs with meals containing a moderate quantity of Potassium.
• Angiotensin receptor blockers (ARBs): Potassium levels can rise due to several high blood pressure treatments. Combining potassium supplements with some blood pressure drugs may result in excess Potassium in the body. However, taking these drugs with food that contains some potassium does not appear to raise potassium levels.
• Potassium-sparing diuretics: This medication can raise the body's potassium levels. If taken alongside Potassium, it might result in the body having too much Potassium. However, taking these drugs with food that contains some potassium does not appear to raise potassium levels.

The common side of Potassium includes the following:

• Nausea
• Vomiting
• Intestinal gas
• Stomach upset
• Diarrhoea
• Confusion
• Irregular or slow heartbeat
• Numbness or tingling in hands, feet, or lips
• Shortness of breath or difficulty breathing
• Unexplained anxiety
• Unusual tiredness or weakness
• Weakness or heaviness of legs

The use of Potassium should be prudent in the following group of special populations.

• Pregnancy: Safe when used within RDA levels.

The RDA for Potassium in pregnant teens is 2600 mg, and for pregnant adults is 2900 mg.

• Paediatrics: When used appropriately, Potassium is likely safe for children. Potassium helps regulate acid and water, developing muscle and helping the body's natural development.

Potassium supplements are the best way to help children get enough Potassium daily.

The RDA for Potassium in paediatrics ranges from 400 mg to 3000 mg.

Dosage Adjustment for Paediatric Patients

Hypokalemia prophylaxis

For ongoing drug losses, including diuretics

Less than a month: 1 to 2 mEq/kg /day of BID but a single dose should not exceed an average adult single dose of 20 mEq/dose, although some patients may require a single dosage up to 40 mEq/dose or higher based on lab values and ongoing losses.

Hypokalemia

Mild to moderate

Less than 1 month: 2 to 5 mEq/kg orally in divided doses but not to exceed 1 to 2 mEq/kg as a single dose or 20 mEq/kg, whichever is less; consider intravenous administration if the deficit is severe or ongoing losses.

Severe

0.5 to 1 mEq/kg/dose but not to exceed 40 mEq/dose; infuse at a rate of 0.5 mEq/kg/hr; monitor serum concentrations 1-2 hr after completion of infusion; Based on lab values repeat the dose as necessary. In case of severe depletion or ongoing losses may require more than 200% of normal daily maintenance.

• Geriatrics: There is no sufficient scientific evidence traceable regarding the use and safety of Potassium for use in special populations.
• Lactating mothers: The normal potassium ion content of human milk is about 13 mEq per litre, showing the ability of Potassium supplements to pass into breast milk.

The RDA for Potassium in pregnant teens is 2500 mg, and for pregnant adults is 2800 mg.

Dosage Adjustment in Kidney Impairment

Because there is a risk of developing hyperkalemia in patients with impaired kidney function, especially if they take RAAS inhibitors or nonsteroidal anti-inflammatory drugs, starting these individuals at the low end of the recommended dosage range is usually best. Serum potassium levels should also be regularly checked, and renal function should be evaluated regularly.

Dosage Adjustment in Hepatic Impairment

The standard starting dose for patients with cirrhosis should be at the low end of the dosage range, and the serum potassium level should be checked often.

The physician should be vigilant about the knowledge pertaining to identifying and treating overdosage of Potassium. Overdosage of Potassium causes hyperkalemia, which is characterized by palpitations, irregular heartbeats, and possibly fatal cardiac arrhythmias.

There is no specific antidote or treatment for excessive intake of supplemental Potassium. When an overdose is suspected, Potassium should be terminated immediately and any agents with potassium-sparing properties. Acute, life-threatening cardiac arrhythmias can be controlled with the help of calcium chloride infusion, dextrose and insulin in water, and correction of acidosis with sodium bicarbonate. Supportive therapy should also be given, addressing any symptoms that persist or worsen. Physical treatment might be added if necessary.

Biochemistry Profile of Potassium

Potassium (K) is an element with an atomic number of 19, which indicates that it has 19 protons in its nucleus. Its atomic mass is about 39.1 atomic mass units (AMU), and how easily it can lose its outermost electron dramatically affects how it will behave chemically. In biochemistry, Potassium is a crucial mineral essential to preserving cell function. It controls the cell membrane's potential, which affects how well nerve impulses are transmitted and how hard muscles contract. To correct biological processes, its levels are carefully watched. The balance of Potassium, which is primarily present inside cells, is regulated by the kidneys, hormones like aldosterone, and food intake. Health problems, including hypokalemia or hyperkalemia, which impact heart rhythm, muscular weakness, and more, can result from deviations from the ideal range. The functions of Potassium in biochemistry include pH control, enzyme activation, and fluid balance. Due to its reactivity and 19-proton atomic structure, which makes it easy to donate an electron, it plays a vital role in biological processes and electrical signalling.

Kinetic profile:

• Absorption: Potassium is mainly absorbed in the small intestine through active transport mechanisms. Dietary consumption, hormones (aldosterone), and general potassium levels in the body all influence how much Potassium is absorbed.
• Distribution: Potassium circulates throughout the body's intracellular and extracellular fluids after absorption. It is essential for preserving regular cellular operation, nerve transmission, and muscle contractions.
• Metabolism: The body's metabolism doesn't significantly alter Potassium's metabolism. Renal (kidney) excretion and cellular absorption are the main mechanisms controlling its levels.
• Elimination: The proximal tubules re-absorb most of the excess Potassium that the kidneys have filtered. The hormone aldosterone influences this mechanism. The kidneys can produce more or less potassium excretion depending on the amount the body demands.