POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride replaces potassium ions lost from the body; dextrose provides caloric supplementation and prevents ketosis; sodium chloride maintains electrolyte balance and hydration.
| Metabolism | Potassium is excreted primarily by kidneys; dextrose is metabolized to CO2 and water; sodium chloride is excreted renally. |
| Excretion | Potassium: renal excretion (90-95%), with minor fecal (<5%) and negligible biliary elimination. Dextrose: primarily metabolized to CO2 and water. Sodium: renal excretion (95-100%) with minor fecal loss. |
| Half-life | Potassium: terminal half-life ~2-3 hours in plasma, but whole-body turnover is slower; clinical context: dosing intervals depend on renal function and serum K+ monitoring. Dextrose: rapidly cleared, half-life <15 minutes. Sodium: not applicable as steady-state regulated by renal function. |
| Protein binding | Potassium: not protein-bound (0%). Dextrose: not bound. Sodium: not bound. |
| Volume of Distribution | Potassium: Vd ~4-6 L/kg (total body water), reflecting distribution primarily in intracellular (98%) and extracellular (2%) compartments. Dextrose: Vd ~0.2-0.3 L/kg (extracellular fluid). Sodium: Vd ~0.6-0.7 L/kg (total body water). |
| Bioavailability | Intravenous: 100% for all components. Oral potassium: ~90% absorbed; not applicable for this product (IV only). Dextrose and sodium: 100% IV bioavailability. |
| Onset of Action | Intravenous: immediate pharmacologic effect (within seconds to minutes) for electrolyte correction; dextrose effect on blood glucose within 1-2 minutes. |
| Duration of Action | Potassium: duration of serum elevation ~2-4 hours after IV infusion, but total body potassium repletion requires hours to days. Dextrose: duration of blood glucose elevation ~30-60 minutes, depending on insulin response. |
| Molecular Weight | 74.55 |
Intravenous infusion of 0.037% potassium chloride in 10% dextrose and 0.9% sodium chloride. The typical adult dose is 500-1000 mL as a continuous infusion at a rate of 1-2 mL/min (equivalent to 0.37-0.74 mg/min potassium chloride), adjusted based on serum potassium levels, with maximum infusion rate of 10 mEq/h potassium and daily maximum of 200 mEq potassium. Frequency: continuous infusion as needed.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR 30-50 mL/min: reduce infusion rate by 25% and monitor serum potassium closely. For GFR 15-29 mL/min: reduce dose by 50% and avoid if hyperkalemia risk. For GFR <15 mL/min: contraindicated unless dialysis is available; use only with extreme caution and frequent monitoring. |
| Liver impairment | Child-Pugh Class A: no adjustment. Child-Pugh Class B: reduce infusion rate by 25% and monitor serum potassium. Child-Pugh Class C: reduce dose by 50% and avoid if ascites or edema due to fluid and dextrose load. |
| Pediatric use | Weight-based: 0.5-1 mEq/kg/day potassium chloride, infused as 0.037% KCl in 10% dextrose and 0.9% sodium chloride at a rate not exceeding 0.5 mEq/kg/h. Maximum concentration: 0.037% (5 mEq/L) per peripheral line. Monitor serum potassium and glucose closely. |
| Geriatric use | Start at low end of dosing range, typical infusion rate 0.5-1 mL/min (0.185-0.37 mg/min potassium chloride). Monitor renal function and serum potassium more frequently due to age-related decline in GFR. Avoid if significant renal impairment or hyperkalemia risk. |
| 1st trimester | Potassium chloride, dextrose, and sodium chloride are essential nutrients; no increased risk of major malformations when used at physiological doses. However, use only if clearly needed due to maternal electrolyte disturbances. |
| 2nd trimester | Safe at physiological doses; monitor maternal electrolytes and fluid balance to avoid hyperkalemia, hyperglycemia, or hypernatremia. |
| 3rd trimester | Safe at physiological doses; avoid excessive administration to prevent fetal electrolyte disturbances or fluid overload. Use caution in preeclampsia. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium, chloride, and sodium are actively transported across the placenta; dextrose crosses via facilitated diffusion. Fetal serum levels equilibrate with maternal levels. No evidence of fetal harm at therapeutic doses. |
| Breastfeeding | Potassium, dextrose, and sodium chloride are normal constituents of breast milk. When administered at standard replacement doses, no adverse effects on the nursing infant are expected. Monitor maternal serum electrolytes if high doses are used. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride are endogenous substances and not associated with teratogenicity at standard doses. No fetal risks have been identified in any trimester when administered appropriately for maternal indications. |
| Fetal Monitoring | Monitor serum electrolytes (potassium, sodium, glucose), fluid balance, and renal function. During labor, monitor fetal heart rate and uterine activity if given intravenously. |
| Fertility Effects | No known adverse effects on fertility. Potassium, dextrose, and sodium chloride are essential nutrients and do not impair reproductive function. |
■ FDA Black Box Warning
Concentrated potassium chloride solutions are lethal if given undiluted; must be diluted and administered slowly via central line.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaHyperglycemia with ketoacidosis (unless corrected)HypernatremiaSevere renal impairment with oliguria or anuriaAcute dehydration with hypernatremiaEdema with sodium retentionKnown hypersensitivity to any component
| Precautions | Monitor serum potassium, glucose, and electrolytes; risk of hyperkalemia, hyperglycemia, and fluid overload; use with caution in renal impairment, cardiac disease, and diabetic patients. |
| Food/Dietary | No specific food interactions. Dietary potassium intake should be monitored in patients at risk for hyperkalemia. Avoid excessive consumption of potassium-rich foods (e.g., bananas, oranges, potatoes) if potassium levels are high. |
| Clinical Pearls | This solution provides maintenance fluid, electrolytes (K+, Na+, Cl-), and dextrose. Monitor serum potassium closely, especially in renal impairment. Avoid in patients with hyperkalemia, severe renal failure, or anuria. Use with caution in heart failure or conditions with fluid overload. Verify potassium concentration: 0.037% = 5 mEq/L K+. |
| Patient Advice | This medication is given through a vein to replace fluids, sugar, and potassium. · Tell your doctor if you have kidney problems, heart disease, or are on a low-potassium diet. · Report any signs of allergic reaction: rash, itching, swelling, severe dizziness. · You may experience discomfort at the IV site; inform your nurse if it becomes painful or swollen. |
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