Porphyria Educational Services
PORPHYRIA EDUCATIONAL SERVICES BULLETIN
Vol. 1 No. 47 ~
November 14, 1999
FOCUS: Fluids and Electrolyte Balance
"Electrolyte": A substance that when dissolved in water
conducts an
electric current. And whatb does this have to do with a
porphyric?
What makes up the electrolytes? The normal electrolytes
include
sodium, chloride, potassium and to some degree calcium.
When a porphyric loses their electrokyte balance small electric
shocks sent through the nervous system signal changes ahead.
Many of these
changes exascebate in changes in our mental well being. They are
also
thought to contribute to seizure activity, and muscle spasms.
Various disturbances of fluid and electrolyte balance are
seen during the acute attack.Dehydration may occur, owing to
persistent
vomiting. Hyponatraemia, secondary to inappropriate antidiuretic
hormone
secretion, may also occur, sometimes first becoming apparent
after
commencing intravenous fluids.
Hyponatraemia can usually be controlled by restricting fluid
intake.
To maintain adequate carbohydrate intake while restricting fluid
intake,
it may be necessary to use higher concentrations of glucose,
administered via a central venous line.
When beginning the onset of an acute attack of porphyria it
is important to safeguiard one'sself by avoiding the nausea and
vomiting
by the use of safe suppositories to avoid the loss of them. The
most common
ly use and known as safe for porphyrics is that of compazine.
Potassium is another factor and if potassium is falling in
lab tests then an added bag of iv potassium along with the
glucose can be
administered. When in remission potassium can be easily restored
to proper levels by
the oral intake of potassium supplements as prescribed by your
physician.
Also it well for a person to drink water often to avoid
dehydration.
Keep your body well hydrated - in the hot summer months as well
as in the
dry heated air indoors in the winter. Drink often. It is better
to drink 8 - 8
oz glasses of water throughout the day than to drink three or
four 15 - 20
oz glasses. The fluid will stay in your body better.
Furthermore, If you are chronically dehydrated, it may take a
week of
"forcing" fluids before you notice a difference in your
hydration. Until
then you may just find yourself going to the bathroom more often.
On average,
however, a person should drink eight 8 oz. glasses per day (about
2 quarts). An overweight person should drink and additional glass
for
every 25 pounds of excess weight; those who exercise or are
experiencing hot or
dry weather should increase their intake as well. Water is best
cold, but not
ice water. Cold water instead of ice water is good not only for
taste, but the
cold water is adsorbed into the system more rapidly.
Electrolytes are very important to porphyric patients and they
should
be sure to have them checked regularly and at the beginning of
any acute
porphyric attack in order to avoid the unnecessary mental changes
and
other neurological changes that can occur.