Extracellularintracellular shifts

Potassium movement into cells is enhanced by insulin, b2 agonists, mineralocorticoids, and theophyllines. Acidosis favors potassium shifts from the cell to the extracellular fluid in exchange for hydrogen ions; alkalosis has the opposite effect. These changes are more pronounced with metabolic than with respiratory disturbances of acid-base balance. Vitamin B12 favors potassium uptake and may contribute to acute profound hypokalemia during the treatment of megaloblastic anemias. Acute shifts may be seen with hypokalemic periodic paralysis.

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