Polystyrene Sulfonate

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Contents 1 Introduction 2 Indications 3 Dosage 4 Pharmacokinetics 5 Adverse-effects 6 Mechanism-of-action 7 More General Terms 8 Internet Database 9 References

Introduction

• Tradename: Kayexalate. ( sodium polystyrene sulfonate)

Indications

• non-life-threatening hyperkalemia

Dosage

• 1 g/kg up to 15-60 g PO or 30-50 g
• retention enema (in 33% sorbitol)

• 30-60 g rectally
• hold for 30 minutes if possible
• repeat every hour as needed
• follow with sterile water enema to remove resin from bowel

• Suspension: oral or rectal:

• 1.25 g/5 mL with sorbitol 33% & alcohol 0.3% (500 mL)

Pharmacokinetics

• not absorbed from GI tract
• binds K+ as it passes through the intestine
• onset of action:

• 2-10 hours when given orally
• 3-12 hours when given rectally

• rectal administration is less effective
• 50 grams reduces serum K+ apporoximately 0.5-1 meq/L
  

• elimination via feces

Adverse-effects

• common (> 10%)

• constipation, loss of appetite, nausea/vomiting

• less common (1-10%)

• fecal impactation, hypokalemia, hypocalcemia, hypomagnesemia, sodium retention

• other

• diarrhea
• intestinal necrosis

• colonic necrosis (rare)
• risk is highest with 70% sorbitol [5]

Mechanism-of-action

• cation exchange resin that exchanges K+ for Na+
• each gram of resin binds up to 1 meq of K+ in exchange for 1-2 meq of Na+
• sorbitol is present to induce diarrhea, reducing the risk of fecal impactation

More General Terms

• metabolic agent (metabolic modifier)

Internet Database

PubChem: 169893

References

1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
3. Kaiser Permanente Northern California Regional Drug Formulary, 1998
4. Department of Veterans Affairs, VA National Formulary
5. Presciber's Letter 17(11): 2010 Sodium Polystyrene Sulfonate for Hyperkalemia Detail-Document#: [1] (subscription needed) [2]

polystyrene sulfonate (Kayexalate, Kalimate)