Sodium Polystyrene Sulfonate (Kayexelate)

Indications

Bowel Obstruction (see Small Bowel Obstruction, [[Small Bowel Obstruction]])
Constipation (see Constipation, [[Constipation]])
Inability to Tolerate Sodium Load: use of kayexelate should be carefully considered in these patient populations
- Congestive Heart Failure (see Congestive Heart Failure, [[Congestive Heart Failure]])
- Severe Hypertension (see Hypertension, [[Hypertension]])
- Severe Peripheral Edema (see Peripheral Edema, [[Peripheral Edema]])
Post-Operative Ileus (see Ileus, [[Ileus]])

Sodium Polystyrene Sulfonate Cation Exchange Resin: sodium ions are partially released from the resin and are replaced by potassium ions
- This occurs mostly in the colon, which excretes potassium ions to a greater degree than the small intestine
- Efficiency of potassium binding is highly variable
- Latency of potassium-lowering effect: hours-days
- Small amounts of magnesium and calcium may be bound by the resin, as well

Hypokalemia (see Hypokalemia, [[Hypokalemia]])
Metabolic Alkalosis (see Metabolic Alkalosis, [[Metabolic Alkalosis]]): reported when kayexelate has been given in combination with non-absorbable cation-donating antacids and laxatives (such as magnesium hydroxide and aluminum carbonate)

Gastrointestinal Hemorrhage (see Gastrointestinal Hemorrhage, [[Gastrointestinal Hemorrhage]]): most cases have occurred in association with concomitant sorbitol use
Intestinal Necrosis/Perforation (see xxxx, [[]]): most cases have occurred in association with concomitant sorbitol use
- Cases associated with fatality have been reported
Ischemic Colitis (see Ischemic Colitis, [[Ischemic Colitis]]): most cases have occurred in association with concomitant sorbitol use