POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions necessary for maintenance of acid-base balance, isotonicity, and electrodynamic characteristics of cells. Potassium is the principal intracellular cation and is essential for nerve impulse transmission, muscle contraction, and enzymatic function. Dextrose provides calories and may reduce protein and nitrogen loss. Sodium chloride maintains osmotic pressure and fluid balance.
| Metabolism | Potassium chloride is not metabolized; excreted renally. Dextrose undergoes metabolism via glycolysis. Sodium chloride is not metabolized. |
| Excretion | Potassium is primarily excreted renally (approximately 90%) via glomerular filtration and tubular secretion, with about 10% eliminated in feces and minimal biliary excretion. Dextrose and sodium are fully metabolized or excreted renally. |
| Half-life | Potassium's terminal half-life is approximately 12-24 hours in patients with normal renal function, reflecting redistribution and slow elimination; prolonged in renal impairment. Dextrose half-life is minutes due to rapid metabolism. Sodium half-life is 2-3 days. |
| Protein binding | Potassium: 0% bound. Dextrose: 0% bound. Sodium: 0% bound. |
| Volume of Distribution | Potassium Vd: approximately 0.5 L/kg (reflects distribution into intracellular and extracellular fluid). Dextrose Vd: ~0.2 L/kg (extracellular and total body water). Sodium Vd: 0.3-0.5 L/kg (extracellular fluid volume). |
| Bioavailability | Intravenous: 100% for all components. |
| Onset of Action | Intravenous infusion: Immediate correction of hypokalemia is concentration/rate-dependent; dextrose effects on blood glucose occur within minutes; sodium effects on volume and osmolality begin within minutes. |
| Duration of Action | Potassium effect lasts 1-2 hours after acute infusion; sustained repletion requires continuous administration. Dextrose action lasts 1-2 hours post-infusion. Sodium effect persists for hours to days depending on fluid balance. |
| Molecular Weight | 74.55 |
Intravenous infusion, 1000 mL to 2000 mL per day at a rate of 100-200 mL/hour, providing 37 mEq potassium per liter, adjusted based on serum potassium and fluid/electrolyte needs.
| Dosage form | INJECTABLE |
| Renal impairment | GFR <30 mL/min: Avoid use due to risk of hyperkalemia; consider alternative potassium replacement. GFR 30-50 mL/min: Use with caution, monitor serum potassium closely; maximum infusion rate 10 mEq/hour. GFR >50 mL/min: No adjustment necessary. |
| Liver impairment | Child-Pugh A: No adjustment needed. Child-Pugh B: Monitor serum potassium; consider reduced rate if ascites present. Child-Pugh C: Avoid use unless potassium deficit severe; monitor closely. |
| Pediatric use | Weight-based dosing: 0.5-1 mEq/kg potassium per day, administered as continuous infusion in compatible IV fluid; maximum rate 0.5 mEq/kg/hour. For solution concentration, each liter provides 37 mEq potassium; adjust volume accordingly. |
| Geriatric use | Start at lower end of dosing range (e.g., 1000 mL/day) with infusion rate not exceeding 100 mL/hour; monitor renal function and serum potassium frequently due to age-related decline in GFR and increased risk of hyperkalemia. |
| 1st trimester | Potassium chloride is a normal component of body fluids; at physiological concentrations considered safe. However, hyperkalemia risk must be avoided; use only if clearly needed and monitor serum potassium. |
| 2nd trimester | Same as T1; no known teratogenicity at therapeutic doses. Monitor serum potassium and ECG if infused intravenously. |
| 3rd trimester | Use cautiously due to risk of hyperkalemia in mother and neonate; may affect fetal heart rate if maternal levels are excessively high. Generally considered safe at recommended doses. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium crosses the placenta by active transport and passive diffusion; fetal serum potassium levels are similar to maternal. In cases of maternal hyperkalemia, elevated fetal potassium levels may occur. |
| Breastfeeding | Potassium chloride is a normal constituent of breast milk; supplementation at usual doses is considered compatible with breastfeeding. However, avoid excessive doses that could lead to maternal hyperkalemia, which may affect milk composition. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Potassium chloride is not teratogenic. Dextrose and sodium chloride are physiological components; high doses of dextrose may cause fetal hyperinsulinemia and hypoglycemia at delivery. First trimester: no known teratogenic risk. Second trimester: no known fetal harm. Third trimester: maternal hyperglycemia from dextrose may cause fetal macrosomia and neonatal hypoglycemia. |
| Fetal Monitoring | Monitor maternal serum electrolytes (potassium, sodium, chloride), blood glucose, and renal function. Fetal monitoring: assess for fetal distress via heart rate monitoring if oxytocin used. Neonatal monitoring: observe for hypoglycemia if maternal hyperglycemia. |
| Fertility Effects | No known adverse effects on fertility. Dextrose and sodium chloride are physiological; potassium chloride at therapeutic doses does not impair reproductive function. |
■ FDA Black Box Warning
No black box warning for this combination product. Potassium chloride concentrate for injection (not this product) has a boxed warning regarding fatal hyperkalemia if administered undiluted.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguria or anuriaAcute dehydrationAdrenal insufficiency (Addison disease)Concomitant use with potassium-sparing diuretics (unless closely monitored)Crush syndrome or severe hemolytic reactions
| Precautions | Risk of hyperkalemia, which can be fatal; monitor serum potassium levels., Use with caution in patients with renal impairment, cardiac disease, or conditions predisposing to hyperkalemia., Solution may contain aluminum; use with caution in renal impairment., Do not administer simultaneously with blood products through same IV line. |
| Food/Dietary | Excessive intake of potassium-rich foods (e.g., bananas, oranges, spinach, avocados, potatoes) and salt substitutes containing potassium chloride may increase risk of hyperkalemia. Avoid concurrent use of potassium-sparing diuretics (e.g., spironolactone) and ACE inhibitors/ARBs without monitoring. |
| Clinical Pearls | Contains 5 mEq potassium per liter. Use with caution in renal impairment; monitor serum potassium. Not for rapid potassium repletion; rate limited by dextrose content. Compatible with most IV medications but check for precipitation. Do not administer via central line unless isotonic. |
| Patient Advice | This fluid contains potassium, which helps your heart and muscles work properly. · Tell your doctor if you have kidney problems or are taking potassium supplements or salt substitutes. · Report any chest pain, muscle weakness, or irregular heartbeat during infusion. · Do not consume potassium-rich foods in excess while receiving this IV. · Keep all appointments for blood tests to check your potassium levels. |
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