Suspension of this drug should be freshly prepared and not
stored beyond 24 hours.
The average daily adult dose of the resin is 15 g to 60 g. This is best provided
by administering 15 g (approximately 4 level teaspoons) of KAYEXALATE
one to four times daily. One gram of KAYEXALATE contains 4.1 mEq of sodium;
one level teaspoon contains approximately 3.5 g of KAYEXALATE and 15 mEq of
sodium. (A heaping teaspoon may contain as much as 10 g to 12 g of KAYEXALATE.)
Since the in vivo efficiency of sodium-potassium exchange resins is approximately
33 percent, about one third of the resin's actual sodium content is being delivered
to the body.
In smaller children and infants, lower doses should be
employed by using as a guide a rate of 1 mEq of potassium per gram of resin as
the basis for calculation.
Each dose should be given as a suspension in a small
quantity of water or, for greater palatability, in syrup. The amount of fluid
usually ranges from 20 mL to 100 mL, depending on the dose, or may be simply
determined by allowing 3 mL to 4 mL per gram of resin. Healthcare professionals
should follow full aspiration precautions when administering this product, such
as placing and maintaining the patient in an upright position while the resin
is being administered.
The resin may be introduced into the stomach through a
plastic tube and, if desired, mixed with a diet appropriate for a patient in
renal failure.
The resin may also be given, although with less effective
results, in an enema consisting (for adults) of 30 g to 50 g every six hours.
Each dose is administered as a warm emulsion (at body temperature) in 100 mL of
aqueous vehicle. The emulsion should be agitated gently during administration.
The enema should be retained as long as possible and followed by a cleansing
enema.
After an initial cleansing enema, a soft, large size (French
28) rubber tube is inserted into the rectum for a distance of about 20 cm, with
the tip well into the sigmoid colon, and taped in place. The resin is then
suspended in the appropriate amount of aqueous vehicle at body temperature and
introduced by gravity, while the particles are kept in suspension by stirring.
The suspension is flushed with 50 mL or 100 mL of fluid, following which the
tube is clamped and left in place. If back leakage occurs, the hips are
elevated on pillows or a knee-chest position is taken temporarily. A somewhat
thicker suspension may be used, but care should be taken that no paste is
formed, because the latter has a greatly reduced exchange surface and will be
particularly ineffective if deposited in the rectal ampulla. The suspension is
kept in the sigmoid colon for several hours, if possible. Then, the colon is
irrigated with nonsodium containing solution at body temperature in order to
remove the resin. Two quarts of flushing solution may be necessary. The returns
are drained constantly through a Y tube connection. While the use of sorbitol
is not recommended, particular attention should be paid to this cleansing enema
if sorbitol has been used.
The intensity and duration of therapy depend upon the
severity and resistance of hyperkalemia.
KAYEXALATE should not be heated for to do so may alter the
exchange properties of the resin.
Updated & New
RxList does not provide medical advice, diagnosis or treatment.