BETA - How are potassium levels monitored and managed?

How are potassium levels monitored and managed? What are the signs and symptoms of hyperkalemia? Most common way to monitor potassium levels is through blood. So a serum potassium, which is something that we do very regularly on either something called a basic metabolic panel or BMP or a comprehensive metabolic panel or a CMP. It's very, I would call regular blood work that we do. The frequency of monitoring depends on how severe the hyperkalemia or the elevated potassium levels are. The more severe the levels, more frequent monitoring is. The other kind of monitoring that we do require for patients with hypertasum can be cardiac monitoring, also known as telemetry monitoring. So for patients who have very high potassium levels, like I mentioned earlier, there's a high chance of irregular heart rate. And for that, the patients might require this telemonitoring. Usually that is done in an in hospital setting. So patients end up getting admitted to the hospital. Now in terms of management, again, like I mentioned, it depends on how severe the hyperkalemia is. So for example, for kind of what we call mild hyperkalemia, which is levels that are not too elevated, we can do oral therapies such as potassium binders. The most common one uses Loquelma. What that does, it binds the potassium within the gut of the patient and they just excrete that in stool. So that brings down the potassium level. If the levels are higher, that might require admission to the hospital with telemonitoring. In that case, we can use therapies such as insulin with dextrose to drive the potassium out of the blood into the cells. Also albuterol, which is an asthma medication, has been shown to help with that. In some cases where the potassium level is really, really high or is resistant to everything else that we've done, then dialysis, which is to kind of clean out the blood, would be the next step. The therapies that I would worry in patients with multiple myeloma that can cause high potassium levels are the ones that I associate with a higher level of kidney dysfunction. So as you all know, myeloma patients in general are more prone to having kidney dysfunction and that by itself can cause to dysregulation of potassium metabolism leading to high potassium levels. So whether it is the drug itself or it is a combination of the disease and the severity of the disease, we can have worsening kidney function and as a result, elevated potassium levels. So we monitor patient's kidney levels prior to doing any sort of infusional therapy or injectable therapy for them. What should patients know about potassium supplements? That is a very good question. So I do think supplements have their role and it depends on the kind of supplement. I would be very worried about taking potassium supplements without discussing it with your physician for two major reasons. A, the potassium levels are monitored kind of fairly frequently. So if you're low on potassium, your physician will be able to tell you you're low on potassium and give you potassium supplements. On the flip side, if you take too much potassium, then you can have issues with hyperkalemia. So when you put both of these together, I would strongly recommend against doing potassium supplements without close monitoring. That being said, there's a lot of good kind of foods and food groups out there that are high in potassium that are fine to take, like for example, bananas or kale, spinach, things of that nature. So I don't particularly think there's a strong need to pursue a specific potassium supplementation unless it's medically required.