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Hyperkalemia (too much potassium in the blood) is a medical emergency. It can induce EKG changes. Emergency aggressive therapy must be initiated.

One way to reduce the serum potassium levels is by driving potassium into the cells. This can be achieved by administering insulin + dextrose. Insulin is needed to move the potassium into the cells, but dextrose (sugar) is also given to avoid hypoglycemia (low blood sugar).

However, calcium gluconate IV is administered temporarily until the potassium is driven into the cells by the insulin. Calcium gluconate does not decrease the blood level of potassium. Instead, it antagonizes the effect of the potassium on the heart muscle.

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