Which medications in the drug class Electrolyte Supplements are used in the treatment of Anorexia Nervosa?

Updated: Jun 10, 2019
  • Author: Bettina E Bernstein, DO; Chief Editor: Caroly Pataki, MD  more...
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Answer

Electrolyte Supplements

Electrolyte repletion is necessary in patients with profound malnutrition, dehydration, and purging behaviors. Repletion may be done orally or parenterally, depending on the patient’s clinical state.

Calcium carbonate (Tums, Oysco, Os-Cal, Maalox)

Calcium moderates nerve and muscle performance by regulating the action potential excitation threshold. It also improves bone density.

Potassium chloride (K-Lor, Klor-Con, Micro-K)

Potassium is essential for the transmission of nerve impulses, contraction of cardiac muscle, maintenance of intracellular tonicity, skeletal and smooth muscle contraction, and maintenance of normal renal function. Gradual potassium depletion occurs via renal excretion or gastrointestinal loss or because of low intake. Depletion usually results from diuretic therapy, primary or secondary hyperaldosteronism, diabetic ketoacidosis, severe diarrhea (if associated with vomiting), or inadequate replacement during prolonged parenteral nutrition.

Potassium depletion sufficient to cause 1 mEq/L drop in the serum potassium level requires a loss of approximately 100-200 mEq of potassium from the total body store.

Calcium gluconate (Cal-Glu)

Calcium gluconate moderates nerve and muscle performance and facilitates normal cardiac function. It can initially be given intravenously, and then calcium levels can be maintained with a high-calcium diet. Some patients require oral calcium supplementation. The 10% intravenous (IV) solution provides 100 mg/mL of calcium gluconate, equaling 9 mg/mL (0.46 mEq/mL) of elemental calcium. One 10-mL ampule contains 93 mg of elemental calcium.

Potassium phosphates, IV

For severe hypophosphatemia (< 1 mg/dL), parenteral preparations of phosphate should be used for repletion. IV preparations are available as sodium or potassium phosphate (K2PO4). Response to IV serum phosphorus supplementation is highly variable and is associated with hyperphosphatemia and hypocalcemia. The rate of infusion and choice of initial dosage should be based on the severity of hypophosphatemia and the presence of symptoms. Serum phosphate and calcium should be monitored closely.

For less severe hypophosphatemia (1-2 mg/dL), oral phosphate salt preparations can be used. Oral preparations are available as sodium or potassium phosphate in capsule or liquid form. Neutra-Phos packets each contain 250 mg of phosphorus; tablets contain 250, 125.6, or 114 mg. Liquid preparations are available as 250 mg/75 mL.


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