Resocal Special Precautions

In administration of Calcium polystyrene sulphonate, have to monitor serum calcium and potassium level regularly during therapy.
The possibility of severe potassium depletion should be considered and adequate clinical and biochemical digoxin. Administration of the resin should be stopped when the serum potassium falls to 5 mmol/L.
Serum calcium levels should be monitored at weekly intervals to detect the early development of hypercalcemia and hypocalcemia are prevented. Hypomagnesemia may also occur and serum magnesium levels should be monitored.
In the event of clinically significant constipation, treatment should be discontinued until normal bowel movement has resumed. Magnesium containing laxatives should not be used.
With oral administration, care should be taken to avoid aspiration, which may lead to bronchopulmonary complications.
The use of sorbitol with polystyrene sulphonate both orally and in enemas has been implicated in cases of colonic necrosis. Although no cause and effect relationship has been established, it is prudent not to use sorbitol with calcium polystyrene sulphonate.
Since effective lowering of serum potassium with calcium resonium may take hours to days, treatment with this drug alone may be insufficient to rapidly improve severe hyperkalemia, often associated with states or rapid tissue breakdown e.g. burn or trauma. In such cases, dialysis is recommended. Where there is hyperkalemia crisis leading to an emergency state, immediate treatment with intravenous glucose and insulin or intravenous sodium bicarbonate may be required to lower the serum potassium level rapidly & briefly while other long-term potassium lowering therapy is prepared.