Utilidades en Medicina Interna

  TREATMENT Appropriate therapy for hypoaldosteronism varies with the cause of the hormone deficiency. Patients with primary adrenal insufficiency, for example, should receive mineralocorticoid replacement therapy (with fludrocortisone at a dose of 0.05 to 0.2 mg/day) to correct the hyperkalemia and with 0.9 percent saline to correct symptomatic hypovolemia. Primary adrenal insufficiency should also be treated with a glucocorticoid, such as hydrocortisone or prednisone , to correct the cortisol deficiency. (See "Treatment of adrenal insufficiency in adults" .) Fludrocortisone is also effective in patients with hyporeninemic hypoaldosteronism [ 1 ]. The typical dose required to normalize the serum potassium is 0.2 to 1 mg/day, substantially higher than the dose in primary adrenal insufficiency. It is therefore likely that these patients have some component of aldosterone resistance, presumably due to the underlying kidney disease. Despite its efficacy, fludrocortis...

 TRATAMIENTO   Arreglar primero el magnesion porque si no no se normalizará el Calcio nunca   1 o 2 g de gluconato cálcico (90 o180 mg de Ca elemental, o 2.25 o 4.5 mmol, cada ampolla de 10 ml de gluconato cálcico al 10% tiene 1 gramo de gluconato cálcico) en 50 ml glucosa o salino en 10-20 minutos Repetir en 30 minutos si no cede.   Si persiste la hipocalcemia (p.ej. pancreatitis severa, hipoparatiroidismo) se sigue de infusion de calcio concentración 1 mg/ml de calcio elemental (11 g de gluconato cálcico + s. salino y glucosado 1000 ml) 1.       Iniciar a 50 ml/h