A patient on amphotericin B develops hypokalemia of 2,3 meq/l. K+ supplementation required:(AIIMS Nov 2013, Nov 2012)

Ans. d. 120-160 mEq over 24 hours (Ref: Cecil Textbook of Medicine by Goldmann / Ausiello, Renal and Genitourinary Diseases 22/e p685)Except in unusual circumstances, the total amount of potassium administered daily should not exceed 200 mEq.Potassium SupplementationA prudent protocol to follow is to add potassium chloride to IV solutions at a final concentration of 40-60 mEq/L and to administer no more than 10-20 mEq/L of potassium per hour.Except in unusual circumstances, the total amount of potassium administered daily should not exceed 200 mEq.IV potassium replacement is indicated for patients with severe hypokalemia and for those who cannot take oral supplementation.For severe deficiency, potassium may be given through a peripheral IV line in a concentration that should not exceed 40 mEq/L, at the rates upto 40 mEq/L/Hour.Continuous ECG monitoring is indicated and the serum potassium levels should be checked every 3-6 hours.For the initial administration, avoid glucose containing fluid to prevent further shift of potassium into the cells.Magnesium deficiency also needs to be corrected at the same time, particularly in refractory hypokalemia.