POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating: safe
No 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. |
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 | 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 chloride are normal constituents of human milk. Exogenous administration at these doses is unlikely to significantly alter milk composition. M/P ratio not applicable as these are endogenous substances. The combination is considered compatible with breastfeeding; however, monitor maternal electrolyte balance and hydration status to avoid excessive milk electrolyte shifts. Infant risk is negligible. |
| Teratogenic Risk |
■ 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 |
Hyperkalemia; severe renal impairment with oliguria or azotemia; hypokalemia with conditions causing cellular potassium release (e.g., burns, trauma); 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. |
Loading safety data…
| 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. |