If a patient with hyperkalemia does not respond to sodium bicarbonate, what other medication can be used?

In cases of hyperkalemia, managing the elevated potassium levels is crucial to prevent serious complications such as cardiac arrest. Sodium bicarbonate is often used to help drive potassium back into cells; however, if the patient does not respond to this treatment, calcium chloride becomes an important alternative.

Calcium chloride is effective because it stabilizes the myocardial membrane, thereby reducing the risk of arrhythmias associated with high potassium levels. It acts quickly to protect the heart and can also help to lower serum potassium levels by competing with potassium at the cellular level.

The other options do not address the immediate need to manage hyperkalemia. Dopamine is primarily used for its inotropic effects in cases of shock or heart failure but does not have a direct effect on potassium levels. Amiodarone is an antiarrhythmic medication used for specific types of arrhythmias and does not serve as a treatment for hyperkalemia. Aspirin is an analgesic and anticoagulant that has no role in the management of high potassium levels.

Therefore, calcium chloride is the most appropriate choice to consider if sodium bicarbonate is not effective in treating hyperkalemia.