POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER
Clinical safety rating: safe
No 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. |
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 | 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 | Compatible with breastfeeding. Potassium, dextrose, and sodium chloride are normal components of breast milk. No M/P ratio available; levels are physiologic and not expected to cause adverse effects in infants. |
| 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. |
■ 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 |
["Hyperkalemia","Severe renal impairment (oliguria, anuria)","Addison's disease","Hypersensitivity to any component"]
| 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"] |
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| 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. |