School of Pharmacy, University of Waterloo, Waterloo, ON, Canada.
Paediatr Drugs. 2013 Feb;15(1):43-8. doi: 10.1007/s40272-012-0003-3.
In pediatric patients at risk of hyperkalemia there are limited treatment or preventive alternatives for this electrolyte imbalance. Oral or rectal sodium polystyrene sulfonate (SPS) has several potential adverse effects, and dietary potassium restriction may compromise nutrition. Pretreatment of infant formula with SPS has been previously studied with promising efficacy. The optimal dosing and contact time has not been fully elucidated for this practice, nor have brand and generic products been compared.
The present study aimed to evaluate the effectiveness of varying amounts of brand and generic SPS for the removal of potassium from formula after 1 and 24 hours.
SPS was added to infant formula in four different amounts measured in milliliters to reflect how a parent or caregiver would measure this product at home. After 1 and 24 hours samples were withdrawn and potassium and sodium levels were measured.
Potassium decreased in all samples, with the greatest reduction after the addition of 10 mL of SPS. Sodium levels increased in all pretreated samples to a greater extent than the potassium reduction. Contact time of either 1 or 24 hours did not impact the amount of potassium removed or the increase in sodium concentration. There were also no differences found between generic and brand SPS products.
The effectiveness of SPS for formula pretreatment appears to have a plateau effect beyond the addition of 20 mL (16.47 g of brand name product, 19.5 g of generic product). This study demonstrates an effective protocol for pretreatment of formula.
在有发生高钾血症风险的儿科患者中，针对这种电解质失衡的治疗或预防方法有限。口服或直肠给予聚苯乙烯磺酸钙（SPS）有多种潜在的不良反应，而限制钾的摄入可能会影响营养。先前已有研究使用 SPS 对婴儿配方奶粉进行预处理，且效果良好。但这种方法的最佳剂量和接触时间尚未完全阐明，也尚未比较过品牌和仿制药产品。
本研究旨在评估不同剂量和品牌的 SPS 对配方奶粉中钾的去除效果，分别在 1 小时和 24 小时后进行评估。
以毫升为单位，向婴儿配方奶粉中添加 SPS，添加量分为 4 个不同水平，以反映父母或护理人员在家中测量该产品的方式。在 1 小时和 24 小时后抽取样本，测量钾和钠的水平。
所有样本中的钾含量均降低，添加 10 毫升 SPS 后降低幅度最大。所有预处理样本中的钠含量均升高，且升高幅度大于钾的减少幅度。接触时间为 1 小时或 24 小时均未影响钾的去除量或钠浓度的增加。此外，仿制药和品牌药 SPS 产品之间也未发现差异。
SPS 对配方奶粉预处理的效果似乎存在一个平台效应，超过添加 20 毫升（16.47 克品牌产品，19.5 克仿制药产品）后效果不再增加。本研究为配方奶粉的预处理提供了一个有效的方案。
