Impaired Absorption of Extended-Release Potassium Chloride in a Patient With a High-Output Ileostomy. Issue 5 (September 2021) - Burka, Abigail T.
Abstract : BACKGROUND: Best practices in the management of ileostomies include use of immediate release (IR) medications and elimination of enteric coated and prokinetic agents. Extended-release (ER) potassium chloride is designed for postpyloric release rather than colonic absorption and is postulated to be an appropriate option for potassium repletion in this patient subset. CASE: We present a patient with an ileostomy who received intravenous ER and IR oral potassium chloride supplementation following diverting loop ileostomy. Clinical responsiveness to ER potassium chloride was poor; 15 to 40 mEq was required to replace 0.1 mEq/L of potassium. However, upon transition to IR potassium chloride, only 6.67 mEq was required to replace 0.1 mEq/L of potassium. CONCLUSIONS: Our experience in this case suggests that patients with surgical alterations to their gastrointestinal tracts who fail to have expected rises in serum potassium levels may benefit from early conversion to IR potassium chloride.