Sodium polystyrene sulfonate
Sodium polystyrene sulfonate (Kayexalate)
Sodium polystyrene sulfonate
( SO-dee-um pol-ee- STY-reen SUL-fon-ayt)
Pregnancy Category: C Kayexalate K-Exit Kionex PMS Sodium Polystyrene Sulfonate SPS (Rx)

Classification: Potassium ion exchange resin

Action/Kinetics: Resin that exchanges sodium ions for potassium ions primarily in the large intestine. Thus, excess amounts of potassium (as well as calcium and magnesium) may be removed. Therapy is governed by daily monitoring of serum potassium levels. Discontinue therapy when serum potassium levels have reached 4-5 mEq/L. Monitor for serum calcium and magnesium levels. Onset, PO: 2-12 hr.

Uses: Hyperkalemia.

Special Concerns: Use with caution in geriatric clients because they are more likely to develop fecal impaction. Use with caution in clients sensitive to sodium overload (e.g., in CV disease) or for those receiving digitalis preparations because the action of these agents is potentiated by hypokalemia. Effective decreases in potassium may take several hours to accomplish; other treatment (e.g., IV calcium or sodium bicarbonate or glucose and insulin) may be considered in states of severe hyperkalemia (e.g., burns, renal failure).

Side Effects: GI: N&V;, constipation, anorexia, gastric irritation, diarrhea (rarely). Fecal impaction in geriatric clients. Electrolyte: Sodium retention, hypokalemia, hypocalcemia, hypomagnesemia. Other: Overhydration, pulmonary edema.

Drug Interactions: Aluminum hydroxide / Risk of intestinal obstruction Calcium- or magnesium-containing antacids or laxatives / Risk of metabolic alkalosis

How Supplied: Powder for reconstitution; Suspension: 15 g/60 mL, 50 g/200 mL

Dosage
?Powder for Suspension, Suspension Hyperkalemia.
Adults: 15 g resin suspended in 20-100 mL water or syrup (to increase palatability) 1-4 times/day. Up to 40 g/day has been used. Pediatric: To calculate dose, use an exchange ratio of 1 mEq potassium/g resin (usually, 1 g/kg dose).
?Enema Hyperkalemia.
Adults: 30-50 g suspended in 100 mL sorbitol or 20% dextrose in water q 6 hr.