Pharmacology. Potassium is the primary intracellular cation. It is essential for the maintenance of acid-base balance and intracellular tonicity; transmission of nerve impulses; contraction of cardiac, skeletal, and smooth muscle; and maintenance of normal renal function (and ability to alkalinize urine). Potassium also functions as an activator in many enzyme reactions and participates in many physiologic processes, such as carbohydrate metabolism, protein synthesis, and gastric secretion. Potassium is critical in regulating nerve conduction and muscle contraction, especially in the heart. A variety of toxins cause alterations in serum potassium levels (see Table I–27).

Indications

1. 
   

   For treatment or prevention of hypokalemia (See Diagnosis of Poisoning).

   
   
2. 
   

   As a supplement to bicarbonate therapy (See Bicarbonate, Sodium) for alkalinization of urine.

Contraindications

1. 
   

   Potassium should be administered cautiously in patients with renal insufficiency or with impairment of renal excretion of potassium (eg, angiotensin-converting enzyme [ACE] inhibitor toxicity and hypoaldosteronism, potassium-sparing diuretics) to avoid the potential for serious hyperkalemia.

   
   
2. 
   

   Potassium should be administered cautiously in patients with impairment of intracellular transport of potassium (due to inhibition of the Na+/K+

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