Medical intervention to prevent metabolic imbalances associated with tumor lysis syndrome includes
a. give Kayexalate for hypokalemia.
b. keep urine pH below 7.0.
c. fluid restriction.
d. dietary restriction of potassium and phosphorus foods.
D
Electrolytes and arterial blood gases are closely monitored. Dietary restrictions of potassium and phosphorus may be necessary. The goals in treating hyperuricemia are to inhibit uric acid formation and to increase renal clearance. These can be accomplished through the administration of sodium bicarbonate to increase the pH of the urine to above 7.0, which increases the solubility of uric acid, preventing subsequent crystallization. Allopurinol administration can also inhibit uric acid formation. Administration of intravenous fluids may be necessary early in the course of treatment if inadequate hydration exists. If potassium levels rise dangerously, Kayexalate (sodium polystyrene sulfonate) may be given orally, or if the patient is unable to tolerate oral medications because of nausea and vomiting, rectal instillation may be used.
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