Drug Study: Potassium Citrate (ACALKA)

GENERIC NAME:
Potassium Citrate

BRAND NAME:
Acalka

CLASSIFICATION:
Antiurolithic

DOSAGE:
10 mEq

MECHANISM OF ACTION:
The aim of the treatment is to restore the level of the urinary citrate and to increase the pH of urine to 6-7, and to this end, the dosage pattern are:
- In patients with slight hypocitraturia start the treatment with a dose of 30mEq (3 tabs/day, divided into 3 takings daily. It is recommended to take the tablets 30 minutes after meals. Approx 24 hrs after having started the treatment, make a determination of urinary citrate and pH, and adjust the dose in accordance with the needs of the patient. If necessary, the dose can be increased, though it is not advisable to exceed the dose of 100 mEq (10 tablets)/day.

INDICATION:
-Treatment of patients with renal lithiasis and hypocitraturia, chronic formers of calcium oxalate, phospate calculia.
- Uric acid lithiasis alone or accompanied by calcium lithiasis

CONTRAINDICATIONS:
- Renal insufficiency¨ Persistent alkaline urinary infections
- Obstruction of the urinary tract
- Hyperpotassemia¨Adrenal insufficiency
- Respiratory or metabolic alkalosis
- Active peptic ulcer
- Intestinal obstruction
- Patients submitted to anticholinergic therapy
- Patients with slow gastric emptying.

SIDE EFFECTS/ ADVERSE EFFECTS:
- Slight gastrointestinal disorders may appear which can be palliated by means of the joint administration of food.

NURSING IMPLICATIONS/RESPONSIBILITIES:

- The tablets must not be masticated or diluted. The active component of Acalka is contained with a porous wax matrix. As this was matrix is insoluble, it can be eliminated in visible form in the feces. The active component, however, has been released in the gastrointestinal tract.
- Must not be administered to patients receiving potassium-sparing diuretics (traimterene, spirolactone, or amyloride).
- It is advisable to carry out an evaluation of electrolytes (Na-K-Cl) and CO2, creatinine and hemogram every 4 hrs.
- It is recommended that the patients in treatment with Acalka follow a diet w/o salt and increase the intake of fluids.
- The recommended treatment in case of hyperpotassemia is: IV administratioin f 10% dextrose solution, containing 10-12 units of insulin/1000ml. Correction of the possible acidosis with IV sodium bicarboate and hemodialysis or peritoneal dialysis.


2 Comments

  1. Edgardo
    Posted July 9, 2008 at 5:42 pm | Permalink

    I have one kidney. My cretinine, BUN, Tryglicerides are OK. My ulrasound shows 3.4mm lithiasis inside kidney, but no pain. Im taking Acalca 3X day, My urine ph is 7. My water drink is alkaline. Im a stone former.
    1.Does Acalca can dissolve stones, like calcium,uric cystines?
    2. Can I take it continously as maintenance?
    3.Is advisable to to maintain kidney from acid isng sodium bicarb?
    4. What meds more better fo kidney maintenance?
    5. Is taking sambong tea Ok for maintenace or does this tea initiates calcium stones?

    Thanks.

  2. ville
    Posted July 17, 2008 at 5:03 am | Permalink

    good day permalink. im a stone former myself and i use to have a 6mm stone on my right kidney. my doctor prescribe acalka 3x a day with 2 tabs sodium bicarbonate and sambong forte tabs for 40 days. ultra sound shows that the stone was not there anymore 40 days later. he does not advice me to take acalka for maintenance. he just advice me after dissolving the stone to drink plenty of water to get at least 2 liters of urine /day to prevent another formation yes you have to measure your urine output to determine your liquid input, cause some of our water is lost somewhere else like sweat etc. but to this day i think i have a stone again cause i feel a slight pain in my right plank like the one i had before. acalka side effect on my part includes stomach gas nothing else. you can take sambong tea cause it will increase your urine output since its a diuretics. happy stone flushing

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