Figure 1: Mechanism of Action of Drugs for Hyperkalaemia.

1: Shift K⁺ into cells. A: β2 agonists and insulin stimulate the Na⁺/K⁺ ATPase allowing exchange of extracellular K⁺ for intracellular sodium. B: Sodium bicarbonate stimulates the HCO₃–/K⁺ cotransporter promoting HCO₃– and K⁺ cotransport in exchange for intracellular sodium. 2: Promote K⁺ removal. C: Through the urine. Loop diuretics work on the thick ascending limb of the loop of Henle inhibiting the Na⁺/K⁺/2Cl^– cotransporter and resulting in decreased Na⁺ and K⁺ reabsorption. D: Via the gastrointestinal tract (GI). Sodium zirconium cyclosilicate, patiromer, and sodium polystyrene sulfate work by binding K⁺ in exchange for H⁺, Ca²⁺, and Na⁺, respectively, in the GI lumen, allowing more K⁺ excretion. ECF = extracellular fluid; ICF = intracellular fluid; S = sorbitol; TAL = thick ascending limb. Source: Sidhu et al. 2020.[62] Adapted with permission from Wolters Kluwer Health.