Source:http://www4.wiwiss.fu-berlin.de/dailymed/resource/drugs/1476
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Kayexalate (Powder, For Suspension)
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| dailymed-instance:dosage |
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 thirdof 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. 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, such as sorbitol. 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, thecolon 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. Particular attention should be paid to this cleansing enema when 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.
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| dailymed-instance:descripti... |
KAYEXALATE, brand of sodium polystyrene sulfonate is a benzene, diethenyl-polymer, with ethenylbenzene, sulfonated, sodium salt and has the following structural formula: The drug is a cream to light brown finely ground, powdered form of sodium polystyrene sulfonate, a cation-exchange resin prepared in the sodium phase with an in vitro exchange capacity of approximately 3.1 mEq (in vivo approximately 1 mEq) of potassium per gram. The sodium content is approximately 100 mg (4.1 mEq) per gram of the drug. It can be administered orally or in an enema.
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| dailymed-instance:clinicalP... |
As the resin passes along the intestine or is retained in the colon after administration by enema, the sodium ions are partially released and are replaced by potassium ions. For the most part, this action occurs in the large intestine, which excretes potassium ions to a greater degree than does the small intestine. The efficiency of this process is limited and unpredictably variable. It commonly approximates the order of 33 percent but the range is so large that definitive indices of electrolyte balance must be clearly monitored. Metabolic data are unavailable.
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| dailymed-instance:contraind... |
KAYEXALATE is contraindicated in the following conditions: patients with hypokalemia, patients with a history of hypersensitivity to polystyrene sulfonate resins, obstructive bowel disease, neonates with reduced gut motility (postoperatively or drug induced) and oral administration in neonates .
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| dailymed-instance:supply |
KAYEXALATE is available as a cream to light brown, finely ground powder in jars of 1 pound (453.6 g), NDC 0024-1075-01. Store at 25��C (77��F); excursions permitted to 15�����30��C (59�����86��F) [see USP Controlled Room Temperature]
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| dailymed-instance:overdosag... |
Biochemical disturbances resulting from overdosage may give rise to clinical signs and symptoms of hypokalemia, including: irritability, confusion, delayed thought processes, muscle weakness, hyporeflexia, which may progress to frank paralysis and/or apnea. Electrocardiographic changes may be consistent with hypokalemia or hypercalcemia; cardiac arrhythmias may occur. Hypocalcemic tetany may occur. Appropriate measures should be taken to correct serum electrolytes (potassium, calcium), and the resin should be removed from the alimentary tract by appropriate use of laxatives or enemas.
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| dailymed-instance:genericMe... |
sodium polystyrene sulfonate
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| dailymed-instance:fullName |
Kayexalate (Powder, For Suspension)
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| dailymed-instance:adverseRe... |
KAYEXALATE may cause some degree of gastric irritation. Anorexia, nausea, vomiting, and constipation may occur especially if high doses are given. Also, hypokalemia, hypocalcemia, and significant sodium retention, and their related clinical manifestations, may occur . Occasionally diarrhea develops. Large doses in elderly individuals may cause fecal impaction . Rare instances of colonic necrosis have been reported. Intestinal obstruction due to concretions of aluminum hydroxide, when used in combination with KAYEXALATE, has been reported. The following events have been reported from worldwide post marketing experience:
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| dailymed-instance:name |
Kayexalate
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