POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride is essential for maintaining cellular membrane potential, nerve impulse transmission, and muscle contraction. Dextrose provides a source of calories and may spare protein. Sodium chloride helps maintain electrolyte balance and hydration.
| Metabolism | Potassium: excreted primarily by kidneys (90-95%), with minor losses in feces and sweat. Dextrose: metabolized to CO2 and water via glycolysis and Krebs cycle. Sodium: excreted primarily by kidneys. |
| Excretion | Renal: >90% of administered potassium is excreted by the kidneys, with the remainder via feces (<10%). Elimination is influenced by aldosterone and distal nephron secretion. |
| Half-life | Potassium has no defined half-life as it is a physiological ion; however, the terminal elimination rate constant corresponds to total body clearance of ~0.2 L/hr/kg. Rapid redistribution occurs within minutes, and renal excretion completes within 6-8 hours under normal renal function. |
| Protein binding | Not bound to plasma proteins (0% bound). Potassium exists as free ion in plasma. |
| Volume of Distribution | Approximately 0.5 L/kg (range 0.4-0.6 L/kg) in adults; distributes primarily in the extracellular fluid (ECF) and exchanges with intracellular compartments. Clinical significance: Larger Vd indicates significant intracellular uptake. |
| Bioavailability | Oral: 90-100% (absorbed rapidly in the small intestine). IV: 100% (intravenous administration). |
| Onset of Action | IV: Onset of potassium replacement effect is immediate upon infusion; however, clinical effect on serum potassium levels is seen within 1-2 hours after starting infusion. ECG changes may appear within 10-30 minutes. |
| Duration of Action | IV: Duration of action is 4-6 hours after infusion cessation, depending on renal function and ongoing losses. The effect on serum potassium is transient and requires continuous infusion for sustained correction. |
Intravenous infusion of 1000 mL over 24 hours as a continuous infusion; rate adjusted based on serum potassium, glucose, and sodium levels and clinical status. Typical rate: 42 mL/hour.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min) due to risk of hyperkalemia. For GFR 30-60 mL/min, use with caution and reduce infusion rate by 50%. Monitor serum potassium closely. |
| Liver impairment | No specific adjustment required; monitor electrolytes and glucose in severe hepatic impairment (Child-Pugh C) due to risk of fluid retention and electrolyte imbalances. |
| Pediatric use | Weight-based: 0.5-1 mEq/kg/day of potassium (as chloride) with dextrose 5% and sodium chloride 0.2% at maintenance rates; typical infusion rate 4 mL/kg/hour. Adjust based on serum potassium and clinical condition. |
| Geriatric use | Start at lower end of dosing range; monitor renal function and serum potassium, glucose, and sodium closely due to age-related decline in GFR and altered fluid balance. |
| 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, chloride, and dextrose are normal milk constituents. No specific M/P ratio available; low risk with usual doses. Monitor infant for electrolyte disturbances if high maternal doses used. |
| Teratogenic Risk | Potassium chloride and the components (dextrose, sodium chloride) are not teratogenic at standard infusion rates. Hypokalemia or hyperkalemia may cause fetal arrhythmias or growth restriction. Dextrose may cause fetal hyperinsulinemia if maternal hyperglycemia occurs. No known structural teratogenicity in any trimester. |
■ FDA Black Box Warning
No FDA black box warning.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Severe renal impairment","Anuria","Hypertonic solutions are contraindicated in intracranial or intraspinal hemorrhage"]
| Precautions | ["Monitor serum potassium, glucose, and sodium levels","Risk of hyperkalemia in patients with renal impairment","Risk of hyperglycemia in diabetic patients","Risk of fluid overload in patients with heart failure or renal disease"] |
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| Fetal Monitoring | Monitor maternal serum electrolytes (potassium, sodium, glucose), fluid balance, urine output, and ECG. Fetal heart rate monitoring if maternal electrolyte abnormalities or rapid infusion. |
| Fertility Effects | No known adverse effects on fertility at therapeutic doses. Unlikely to directly impair reproduction. |