POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions for maintenance of electrolyte balance and cellular function; dextrose provides calories and serves as a source of glucose; sodium chloride provides sodium and chloride ions for maintenance of osmotic pressure and acid-base balance.
| Metabolism | Dextrose is metabolized via glycolysis and the Krebs cycle; potassium and sodium are excreted primarily by the kidneys. |
| Excretion | Potassium is primarily excreted renally (90%) via glomerular filtration and tubular secretion; approximately 10% is eliminated in feces via gastrointestinal secretion. Dextrose is completely metabolized to carbon dioxide and water, with negligible renal excretion. Sodium is excreted renally, with excretion matching intake under normal regulation. |
| Half-life | Potassium has no defined terminal elimination half-life because it is an endogenous ion under homeostatic control; redistribution half-life is approximately 1-2 hours. Dextrose: plasma half-life is <15 minutes due to rapid cellular uptake and metabolism. Sodium: no defined half-life due to tight renal regulation. |
| Protein binding | Potassium: negligible protein binding (<2%). Dextrose: not bound. Sodium: not bound. |
| Volume of Distribution | Potassium: Vd ~0.5 L/kg in total body water; distributes predominantly intracellularly (98% of total body potassium is intracellular). Dextrose: Vd ~0.2 L/kg (extracellular fluid). Sodium: Vd ~0.2 L/kg (extracellular fluid). |
| Bioavailability | Intravenous: 100% for all components. Not administered orally as this formulation; oral potassium has bioavailability ~90% but not applicable here. |
| Onset of Action | Intravenous: potassium's effect on serum levels begins within minutes; dextrose effect on blood glucose is immediate; sodium effect is immediate. |
| Duration of Action | Potassium: duration depends on infusion rate and body distribution; typical infusion effects last for the duration of administration and redistribute over hours. Dextrose: effects on blood glucose last 1-2 hours; sodium: effects persist as long as infusion continues with renal adjustment. |
Intravenous infusion. Dose depends on electrolyte deficits and fluid requirements. Typical adult maintenance: 1-2 mEq/kg/day potassium chloride, dextrose 10% at 100-200 mL/hour, sodium chloride 0.2% as needed. Rate not to exceed 10 mEq/hour potassium chloride.
| Dosage form | INJECTABLE |
| Renal impairment | GFR > 50 mL/min: no adjustment. GFR 10-50 mL/min: reduce potassium dose by 25-50% and monitor serum potassium closely. GFR < 10 mL/min: avoid use or use with extreme caution; potassium dose should not exceed 20 mEq/day unless monitored intensively. |
| Liver impairment | Child-Pugh Class A: no adjustment. Child-Pugh Class B: caution; monitor potassium and ammonia levels. Child-Pugh Class C: use with extreme caution; dextrose may exacerbate hepatic encephalopathy; reduce infusion rate. |
| Pediatric use | Weight-based intravenous infusion. Potassium: 0.5-1 mEq/kg/day for maintenance; not to exceed 1-2 mEq/kg/day. Dextrose 10%: 100-200 mL/kg/day for infants, 60-100 mL/kg/day for older children. Sodium chloride 0.2%: adjust based on sodium needs. Infusion rate: do not exceed 0.5 mEq/kg/hour for potassium. |
| Geriatric use | Start at lower end of dosing range due to age-related decline in renal function. Monitor serum potassium, renal function, and fluid status closely. Avoid rapid infusion; typical rate not exceeding 5 mEq/hour potassium chloride. Reduce dextrose load if glucose intolerance present. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Breastfeeding | Potassium, dextrose, and sodium are normal constituents of breast milk. No specific M/P ratio is available. Use during lactation is considered safe when administered as per standard clinical practice. However, high maternal serum levels could alter milk composition; avoid excessive infusion rates. |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride at these concentrations are physiologic components of body fluids. No teratogenic risk has been associated with these components at standard infusion rates. However, maternal electrolyte disturbances (e.g., hyperkalemia, hyperglycemia) can adversely affect the fetus. First trimester: No specific fetal risk; use only if clearly needed. Second/third trimester: Monitor maternal electrolytes and glucose to avoid fetal distress. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Hypersensitivity to any component","Severe renal impairment with oliguria or anuria","Addison's disease","Concurrent use of potassium-sparing diuretics (relative contraindication)"]
| Precautions | ["Do not administer unless solution is clear and container undamaged","Use with caution in patients with renal insufficiency, heart failure, or conditions predisposing to hyperkalemia","Monitor serum potassium, glucose, and electrolytes during therapy","Risk of hyperkalemia if administered too rapidly or in excessive amounts"] |
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| Fetal Monitoring | Monitor maternal serum potassium, glucose, sodium, and fluid balance. Assess fetal heart rate and uterine activity if indicated. Monitor for signs of hyperkalemia (ECG changes), hyperglycemia (blood glucose), and fluid overload (edema, hypertension). |
| Fertility Effects | No known adverse effects on fertility with these components at therapeutic doses. No specific studies; however, electrolyte imbalances may affect reproductive function. Use as necessary without anticipated impact. |