All are used in hyperkalemia except-
Correct Answer: 50 ml of 50% dextrose
Description: Insulin lowers plasma K+ concentration by shifting K+ into cells. The recommended dose is 10 units of intravenous regular insulin followed immediately by 50 mL of 50% dextrose (D50W, 25 g of glucose total); the effect begins in 10-20 min, peaks at 30-60 min, and lasts for 4-6 h. Bolus D50W without insulin is never appropriate, given the risk of acutely worsening hyperkalemia due to the osmotic effect of hypeonic glucose. (reference: harrisons principles of internal medicine, 19E, page -312)
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