POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions for maintenance of acid-base balance, isotonicity, and electrophysiological function; dextrose provides calories and may restore blood glucose levels; sodium chloride maintains fluid and electrolyte balance. The combination corrects hypokalemia and dehydration.
| Metabolism | Dextrose is metabolized via glycolysis and the Krebs cycle; potassium is excreted primarily by the kidneys; sodium is excreted by the kidneys and sweat. |
| Excretion | Potassium is primarily excreted renally (90%) with minor fecal (10%) elimination. In this formulation, dextrose and sodium chloride are fully metabolized or excreted: dextrose undergoes cellular uptake and metabolism; sodium chloride is renally eliminated with sodium reabsorption and chloride as counterion. |
| Half-life | Potassium has a terminal elimination half-life of approximately 3-4 hours in healthy individuals, reflecting rapid renal clearance. However, redistribution and total body potassium turnover are slower (days) due to large intracellular stores. Clinical context: Half-life is prolonged in renal impairment or hypokalemia, and shortened in hyperkalemia. |
| Protein binding | Potassium is not significantly protein-bound (<5%). Dextrose and sodium chloride are not bound. |
| Volume of Distribution | Potassium Vd is 0.5-0.7 L/kg (approximately 35-50 L in adults), reflecting predominantly intracellular distribution (>98% of body potassium is intracellular). Clinical meaning: Large Vd necessitates loading doses for repletion. |
| Bioavailability | Intravenous: 100% bioavailability. Not administered orally (100% oral bioavailability for oral potassium salts, but this formulation is IV only). |
| Onset of Action | Intravenous: Serum potassium elevation occurs within minutes to hours, with peak effect at 1-2 hours after infusion rate adjustment. Clinical effect (e.g., ECG changes) begins within 30-60 minutes. |
| Duration of Action | Duration of effect after IV administration is 2-4 hours post-infusion, but total body potassium repletion may require prolonged infusion over hours to days. Continuous monitoring is needed. |
| Molecular Weight | 74.55 |
Intravenous infusion at a rate of up to 10 mEq/h potassium chloride, with typical adult dose of 20-40 mEq potassium per 1000 mL of solution (e.g., 1 L of this preparation provides 5 mEq K+). Rate adjusted based on serum potassium and clinical status.
| 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, reduce infusion rate and monitor potassium closely; specific dose reduction not defined, use conservative rates (e.g., ≤5 mEq/h). |
| Liver impairment | No specific Child-Pugh based dose adjustment required, but monitor serum potassium as hepatic impairment may affect potassium homeostasis. Use caution in severe hepatic failure. |
| Pediatric use | Weight-based: 0.5-1 mEq/kg per day as maintenance, rate not to exceed 0.5 mEq/kg/h. For this solution (0.037% KCl = 5 mEq/1000 mL), infusion rate calculated based on desired potassium dose, e.g., 2-4 mL/kg/h for maintenance (providing 0.01-0.02 mEq/kg/h K+). Monitor serum potassium. |
| Geriatric use | Elderly patients may have reduced renal function; use lower initial infusion rates (e.g., ≤5 mEq/h) and monitor serum potassium and renal function closely. Avoid in patients with impaired renal function. |
| 1st trimester | Potassium chloride is a normal constituent of body fluids and is used to correct or prevent hypokalemia. Administration is generally safe when used as directed, but caution is advised in the presence of conditions that predispose to hyperkalemia. No evidence of teratogenicity. |
| 2nd trimester | Safe when used as directed. Monitor serum potassium levels to avoid hyperkalemia. |
| 3rd trimester | Safe when used as directed. May be used to maintain electrolyte balance during labor and delivery. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium freely crosses the placenta, but is regulated by fetal homeostasis. No evidence of accumulation or adverse effects. |
| Breastfeeding | Potassium chloride is a normal component of breast milk and is not expected to cause adverse effects in the breastfed infant. Use caution with high doses or if maternal hyperkalemia occurs. |
| Lactation Rating | Safe |
| Teratogenic Risk | Potassium chloride, as an electrolyte supplement, has no known teratogenic risk. Dextrose and sodium chloride are physiologic. No fetal risks identified in any trimester. |
| Fetal Monitoring | Monitor maternal serum electrolytes, glucose, renal function, and fluid status. Fetal surveillance as per routine obstetric care; no specific monitoring required for this solution. |
| Fertility Effects | No known effects on fertility. Potassium, dextrose, and sodium chloride are physiologic and not associated with reproductive impairment. |
■ FDA Black Box Warning
Concentrated potassium chloride solutions (not this one; this is a dilute solution) have been associated with fatalities due to maladministration; however, this product is a dilute preparation and does not carry a black box warning.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment (oliguria, anuria)Concurrent use with potassium-sparing diuretics (unless careful monitoring)Addison's diseaseAcute dehydrationHeat cramps
| Precautions | Use with caution in patients with severe renal impairment, cardiac disease, or hyperkalemia, Monitor serum potassium levels and renal function, Rapid infusion may cause hyperkalemia and cardiac arrhythmias, Contains dextrose; caution in patients with glucose intolerance, Not for rapid correction of severe hypokalemia |
| Food/Dietary | No direct food interactions with this intravenous solution. However, patients should avoid excessive dietary potassium (bananas, oranges, tomatoes, potatoes, spinach, nuts, avocados) and salt substitutes containing potassium chloride to prevent hyperkalemia. Sodium intake may need monitoring; avoid high-sodium foods if salt restriction is indicated. |
| Clinical Pearls | This solution provides 0.037% potassium chloride (5.0 mEq/L K+), 5% dextrose (50 g/L), and 0.33% sodium chloride (56 mEq/L Na+). Use with caution in patients with renal impairment, hyperkalemia, or conditions predisposing to hyperkalemia (e.g., adrenal insufficiency, potassium-sparing diuretics). Rapid infusion may cause hyperkalemia and cardiac arrhythmias. Monitor serum potassium, glucose, and sodium levels. Not for dilution or as a vehicle for drugs incompatible with dextrose or electrolytes. |
| Patient Advice | This infusion contains potassium, dextrose (sugar), and salt. It is given to correct or prevent electrolyte and fluid imbalances. · Tell your healthcare provider if you have kidney disease, diabetes, or are on a potassium-restricted or low-sodium diet. · Report any symptoms such as muscle weakness, irregular heartbeat, numbness, or tingling, which may indicate potassium imbalance. · This solution provides calories from dextrose; monitor blood glucose if you have diabetes. · Avoid consuming potassium-rich foods (bananas, oranges, potatoes, spinach) or salt substitutes without medical advice while receiving this infusion. |
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