PMS-SODIUM POLYSTYRENE SULFONATE POWDER FOR SUSPENSION 94.3 MG/G [SIN06252P]

Product Info

PMS-SODIUM POLYSTYRENE SULFONATE POWDER FOR SUSPENSION 94.3 MG/G

[SIN06252P]

Indication

INDICATION
Sodium Polystyrene Sulfonate suspension is indicated for the treatment of hyperkalemia.

Dosing

DOSAGE
Suspensions of this drug should be freshly prepared and not stored beyond 24 hours. The average daily adult dose of the resin is 15 to 60g. This is best provided by administering 15 g (approximately 4 level teaspoonfuls) of Kayexalate 1 to 4 times daily. 1 g of resin contains 4.1 mmol of sodium; 1 level teaspoonful contains 3.5 g of resin and 15 mmol of sodium. (A heaping teaspoonful may contain as much as 10 to 12g of resin.) Since the in vivo efficiency of sodium potassium exchange resins is approximately 33%, about one third of the resin’s actual sodium content is being delivered to the body.

In smaller children and infants smaller doses may be employed. Calculation of the dose may be based upon the exchange rate of 1 mmol/g of resin.

Give each dose as a suspension in a small quantity of water or, for greater palatability, in syrup. The amount of fluid usually ranges from 20 to 100 mL, depending on the dose, or may be simply determined by allowing 3 to 4 mL/g of resin. Use of sorbitol is not recommended to combat constipation. 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 a daily enema consisting (for adults) of 30 to 45 g once or twice daily at 6 hour intervals. Each dose is administered as a warm emulsion (at body temperature) in 150 to 200 mL of aqueous vehicle (such as plain water, 10% dextrose in water, or equal parts of water and 2% methylcellulose suspension). The emulsion should be agitated gently during administration. The enema should be retained for as long as possible and followed by a cleansing enema. Use of sorbitol in enemas in contraindicated. After the 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 water or 10% dextrose at body temperature and introduced by gravity, while the particles are kept in suspension by stirring.

The suspension is flushed with 50 or 100 mL of saline solution, 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 a 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.
The intensity and duration of therapy depends upon the severity and resistance of hyperkalemia.

The resin should not be heated as it may alter its exchange properties.

Administer sodium polystyrene sulfonate at least 3 hours before or 3 hours after other oral medications. Patients with gastroparesis may require a 6 hour separation.