POTASSIUM
The
significance of the potassium ion concentrations inside and outside the cardiac
cell membrane was discussed earlier. The effects of increasing
serum K+ can be summarized as (1) a resting potential depolarizing
action and (2) a membrane potential stabilizing action, the latter caused by
increased potassium permea-bility. Hypokalemia results in an increased risk of
early and delayed afterdepolarizations, and ectopic pacemaker activity,
especially in the presence of digitalis. Hyperkalemia depresses ectopic
pacemakers (severe hyperkalemia is required to suppress the SA node) and slows
conduction. Because both insufficient and excess potassium is poten-tially
arrhythmogenic, potassium therapy is directed toward normal-izing potassium
gradients and pools in the body.
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