A 55-year-old man on ICU develops acute severe hyperkalaemia (K+ 7.2 mmol/L). The team considers using sodium zirconium cyclosilicate (Lokelma) as part of the management. What is the mechanism and role of this agent? A It is a loop diuretic B Sodium zirconium cyclosilicate is a non-absorbed oral potassium binder that exchanges sodium for potassium in the GI tract, reducing serum potassium - it has faster onset than calcium resonium (1-6 hours vs 12-24 hours) and is better tolerated; it is used as an adjunct to standard emergency management (calcium, insulin-dextrose, salbutamol) and for ongoing potassium management, but is NOT a substitute for emergency RRT in life-threatening hyperkalaemia C It directly removes potassium from the blood via IV administration D It is a cardiac membrane stabiliser like calcium E It has no role in hyperkalaemia management
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