Management overview for oral potassium poisoning

Oral potassium supplements are available as immediate-release and modified-release preparations. Acute oral potassium poisoning is uncommon, but can cause life-threatening hyperkalaemia, especially in patients with chronic kidney disease. The most serious effect is cardiac arrest due to hyperkalaemia.

Initial assessment includes an urgent serum potassium concentration, electrocardiogram (ECG), and an abdominal X-ray to determine if there are undissolved tablets in the stomach and upper gastrointestinal tract.

Management of oral potassium poisoning is based on whether the patient has hyperkalaemia after the ingestion, with or without cardiac effects, and whether tablets are visible on X-ray. The mainstays of management are continuous ECG monitoring and treatment of hyperkalaemia. Patients with normal kidney function eliminate potassium very efficiently when there is hyperkalaemia, but patients with kidney impairment are likely to need urgent haemodialysis.