| K-hos ® Neutral Tablets: [ Each tablet contains approximately 250 mg of phosphorus, 298 mg of sodium (13.0 mEq) and 45 mg of potassium (1.1 mEq).]
Dosage and administration:
| K-PHOS® ORIGINAL (Sodium Free): Each tablet contains potassium acid phosphate 500 mg [~ 114 mg (3.68 mmol) of phosphorus and 144 mg of K+ ( 3.7 mEq)]. ACTIONS: highly effective urinary acidifier.
INDICATIONS: For use in patients with elevated urinary pH. Helps keep calcium soluble and reduces odor and rash caused by ammoniacal urine. Also, by acidifying the urine, it increases the antibacterial activity of methenamine mandelate / hippurate. DOSAGE:: Two tabs ( dissolved in 6-8 oz. of water) 4 times daily with meals and at bedtime.
| Neutra-Phos ®: (mix with at least 2.5 ounces (75 ml) of water/juice).
Dosage: 1 pkt four times daily with meals and at bedtime. Mild laxative effect possible.
[1 packet equivalent to elemental phosphorus 250 mg (~8 mmol), sodium 164 mg (7.1 mEq), and potassium 278 mg (7.1 mEq) per packet].
Dave’s Tip: Remember that 1 pkt qid = RDA (1000 mg Phosphorus).
| NORMAL LEVELS: 2.4 – 4.5 mg/dl (0.8 – 1.5 mmol/L)
Causes: Decreased intake: malnutrition, malabsorption, vitamin D deficiency, phosphate binders, alcoholism. Shifts from serum into cells: respiratory alkalosis, refeeding, hyperalimentation, effects of insulin/glucagon/androgens. Increased urinary secretion: renal tubular defect, DKA.
Signs (generally seen only with total body depletion and serum PO4 < 1 mg/dL): weakness, rhabdomyolysis, respiratory compromise/failure, CHF, paresthesias, confusion, stupor, seizures, coma, hemolysis, platelet dysfunction, metabolic acidosis.
Therapy: Determine Ca x PO4 product before administering phosphorus: If the product is greater than 60 mg/dl, there is a risk of calcium phosphate precipitation in the cornea, lung, kidney, cardiac conduction system, and blood vessels.
Oral therapy: For Phosphorus > 1 mg/dl (>0.3 mmol/L), oral therapy may be used.
Note: Phosphorus has historically been administered over 4 to 6 hours due to the potential risk associated with high doses and rapid administration (i.e., hypocalcemia, hypotension, metastatic calcification, renal failure). However, most of this data comes from cases of hypercalcemia treated with large doses of intravenous phosphates in which phosphorus levels were typically normal. More aggressive electrolyte replacement is not considered as risky.
National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
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