POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride replenishes intracellular potassium, which is essential for nerve impulse transmission, muscle contraction, and maintenance of normal renal function. Dextrose provides caloric support, and sodium chloride maintains extracellular fluid osmolality.
| Metabolism | Dextrose is metabolized via glycolysis and subsequent oxidative pathways; potassium is excreted primarily by the kidneys (not metabolized); sodium is mainly renally excreted. |
| Excretion | Potassium is primarily excreted renally (90-95%) with minimal fecal loss. Dextrose is metabolized to CO2 and water; sodium and chloride are excreted renally. |
| Half-life | Potassium: not applicable (homeostatic regulation). Dextrose: <15 minutes. Sodium/chloride: no defined half-life. |
| Protein binding | Potassium: not protein-bound. Dextrose: not applicable. Sodium: not protein-bound. Chloride: not protein-bound. |
| Volume of Distribution | Potassium: approximately 0.3 L/kg (total body water). Dextrose: distributes into total body water (0.6 L/kg). Sodium: distributes into extracellular fluid (0.2 L/kg). Chloride: similar to sodium. |
| Bioavailability | Intravenous: 100% for all components. |
| Onset of Action | Intravenous: immediate for potassium, dextrose, and electrolytes. |
| Duration of Action | Potassium: depends on dose and homeostatic mechanisms; dextrose: rapid metabolism; sodium/chloride: depends on renal function. |
| Molecular Weight | Potassium chloride: 74.55 Da; Dextrose: 180.16 Da; Sodium chloride: 58.44 Da |
Intravenous infusion at a rate of 100-200 mL/hour (10-20 g dextrose, 0.45-0.9 g sodium chloride, 37-74 mg potassium chloride per hour) based on electrolyte needs and fluid status; typical maintenance: 1-2 mEq/kg/day potassium, 2-4 g/kg/day dextrose, 1-2 mEq/kg/day sodium.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-60 mL/min: administer with caution, monitor potassium and ECG; GFR <30 mL/min: contraindicated due to risk of hyperkalemia. |
| Liver impairment | Child-Pugh A/B: no adjustment; Child-Pugh C: use with caution due to risk of fluid overload and electrolyte imbalance. |
| Pediatric use | Dose based on weight; typical potassium: 1-2 mEq/kg/day, dextrose: 2-4 g/kg/day, sodium: 1-2 mEq/kg/day; infusion rate not to exceed 0.5-1 mEq/kg/hour potassium. |
| Geriatric use | Start at lower end of dosing range due to decreased renal function; monitor serum potassium and fluid status closely. |
| 1st trimester | Potassium chloride, dextrose, and sodium chloride are essential nutrients; use is generally considered safe when administered for appropriate indications. However, hyperkalemia or fluid overload may pose risks; monitor serum potassium and fluid balance. No teratogenic effects reported at physiological doses. |
| 2nd trimester | Safe for maternal hydration and electrolyte replacement in pregnancy. Avoid excessive potassium administration to prevent hyperkalemia. Monitor maternal serum potassium and glucose levels due to dextrose content. |
| 3rd trimester | Use with caution in third trimester due to risk of fluid overload and hyperglycemia. Prolonged use of high-dose dextrose may cause neonatal hypoglycemia. Potassium supplementation should be guided by serum levels. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium crosses placenta via active transport; dextrose crosses freely; sodium crosses via active transport. At therapeutic doses, transfer is physiologic and not harmful. |
| Breastfeeding | Potassium, dextrose, and sodium chloride are normal constituents of breast milk. Administration to mother does not pose significant risk to infant. However, monitor maternal serum potassium if high doses are given, as hyperkalemia could theoretically affect milk composition. |
| Lactation Rating | L1 - Safe |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride at these concentrations are not associated with increased risk of major birth defects. However, in first trimester, severe electrolyte disturbances may indirectly affect embryogenesis. In second and third trimesters, maternal hypokalemia or hyperkalemia can impair fetal ion homeostasis and organ development. Dextrose infusions may cause maternal hyperglycemia, potentially leading to fetal hyperinsulinism and macrosomia if uncontrolled. Sodium chloride content may contribute to fluid overload and placental edema. Overall, FDA Pregnancy Category C (historical); current evidence suggests minimal teratogenic risk when used appropriately. |
| Fetal Monitoring | Monitor serum potassium, glucose, and sodium levels periodically. Assess maternal fluid status (daily weight, intake/output, edema). Fetal monitoring: consider fetal heart rate tracing and ultrasound for growth if prolonged administration to prevent electrolyte-induced arrhythmias or fluid imbalance. In pregnancy, watch for signs of hypo- or hyperkalemia (ECG changes, muscle weakness), hyperglycemia, and fluid overload. |
| Fertility Effects | No evidence of adverse effects on fertility. Potassium, dextrose, and sodium chloride at these concentrations are physiological and do not impair reproductive function. Severe electrolyte disturbances could theoretically affect ovulation or implantation, but not with normal therapeutic use. |
■ FDA Black Box Warning
Concentrated potassium chloride solutions are lethal if injected rapidly; must be diluted and administered via slow infusion with cardiac monitoring.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaHypernatremiaHyperglycemia with severe dehydration (relative, but absolute if uncontrolled)Anuria or severe renal impairment with oliguriaAcute intracranial hemorrhage (for hypertonic dextrose if used; not for this specific product)Known hypersensitivity to any component
| Precautions | Monitor serum potassium, glucose, and electrolytes frequently; risk of hyperkalemia in renal impairment; avoid rapid infusion; use with caution in heart failure, renal insufficiency, or conditions predisposing to hyperkalemia; extravasation may cause tissue necrosis. |
| Food/Dietary | Avoid excessive intake of potassium-rich foods (e.g., bananas, oranges, spinach) while receiving this solution to prevent hyperkalemia. |
| Clinical Pearls | This solution provides maintenance fluid and electrolytes. Use with caution in patients with renal impairment, heart failure, or hyperkalemia. Monitor serum potassium and glucose levels, especially in diabetics. Do not administer simultaneously with blood products. |
| Patient Advice | Inform your healthcare provider if you have kidney problems, heart disease, or diabetes. · Report any signs of hyperkalemia such as muscle weakness, fatigue, or palpitations. · This solution contains dextrose and may affect blood sugar levels. · Do not adjust the infusion rate yourself. |
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