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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.