Stabilization of the cardiac membrane 
Calcium
Calcium directly antagonizes the toxic myocardial effects of hyperkalemia by reducing the threshold potential of cardiac myocytes leading to stabilization of the membrane potential, with or without changing the serum potassium concentration. [22] It is indicated when serum potassium concentration is > 6.5 mmol/L or when it is > 6.0 mmol/L with EKG changes. [23] Calcium for injection is available as the chloride or gluconate salt. Calcium gluconate is the preferred agent due to the potential for extravasation with calcium chloride. [24] The suggested dose of calcium gluconate is 1,000 mg (10 mL of a 10 % solution) infused over 2 to 3 minutes, with constant cardiac monitoring. The dose can be repeated in 5 to 10 minutes if EKG changes persist. The use of intravenous calcium to treat arrhythmias in the setting of hyperkalemia is not based on robust evidence. It was shown to be effective in animal experiments and case reports. [25-27] However, administration of intravenous calcium is believed to be an important and life-saving approach in hyperkalemia with life-threatening EKG changes. [28 29] Peripheral vasodilation, hypotension, bradycardia, and arrhythmias are noted adverse reactions with intravenous calcium administration.[30]