POTASSIUM CHLORIDE 0.075% 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 maintains intracellular tonicity and is essential for nerve conduction, muscle contraction, and acid-base balance. Dextrose provides calories and may decrease protein and nitrogen loss. Sodium chloride maintains extracellular fluid volume and electrolyte balance.
| Metabolism | Potassium is primarily excreted unchanged by the kidneys. Dextrose undergoes glycolysis and is metabolized to carbon dioxide and water. Sodium is excreted predominantly by the kidneys. |
| Excretion | Potassium is primarily excreted renally (approximately 90%) via glomerular filtration and distal tubular secretion. Fecal elimination accounts for ~10% under normal conditions. Dextrose and sodium chloride are fully metabolized or excreted renally. |
| Half-life | Potassium has no true elimination half-life due to tight homeostatic regulation; the terminal half-life of potassium tracer is approximately 12-14 hours in healthy individuals. Clinically, redistribution half-life is ~1 hour. Effect persists as long as infusion continues, with transient changes after cessation. |
| Protein binding | Potassium is minimally protein-bound (<2%); no specific binding protein. Dextrose and sodium chloride are not protein bound. |
| Volume of Distribution | Potassium: approximately 0.5 L/kg (total body water). Dextrose: distributes into total body water (~0.6 L/kg). Sodium chloride: distributes into extracellular fluid (~0.2 L/kg). For interpretation: Vd for potassium reflects its primarily intracellular distribution. |
| Bioavailability | Intravenous: 100% (complete bioavailability). Not administered via other routes for this formulation. |
| Onset of Action | Intravenous: Correction of hypokalemia occurs within minutes to hours depending on infusion rate; serum potassium rises within 1-2 hours with appropriate dosing. |
| Duration of Action | Duration is dependent on infusion rate and renal function; effects persist while potassium is administered, with steady state achieved in 4-6 hours. After discontinuation, levels decline over several hours if no maintenance. |
| Molecular Weight | 74.55 |
Intravenous infusion; rate determined by fluid and electrolyte needs; typical adult rate: 100-200 mL/hour (contains 10 g dextrose, 9 mEq sodium, 0.075 g potassium chloride per 100 mL); maximum potassium infusion rate: 10 mEq/hour (13.3 mL/hour of this solution) unless critical hypokalemia.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (eGFR <30 mL/min/1.73 m²) due to risk of hyperkalemia and fluid overload; for eGFR 30-60 mL/min/1.73 m², use with caution, monitor potassium levels, reduce infusion rate to ≤5 mEq potassium/hour (6.7 mL/hour). |
| Liver impairment | No specific dose adjustment required for Child-Pugh A or B; for Child-Pugh C, monitor for fluid overload and electrolyte imbalances due to reduced albumin and altered drug metabolism; consider reducing infusion rate and volume. |
| Pediatric use | Weight-based dosing: 5-20 mL/kg/day (providing dextrose 0.5-2 g/kg/day, sodium 0.45-1.8 mEq/kg/day, potassium 0.0375-0.15 mEq/kg/day); adjust rate to maintain serum potassium 3.5-5.0 mEq/L; maximum potassium infusion rate: 0.5-1 mEq/kg/hour (0.67-1.33 mL/kg/hour of this solution). |
| Geriatric use | Start at lower end of dosing range (e.g., 50-100 mL/hour) due to decreased renal function and increased risk of hyperkalemia and fluid overload; monitor serum potassium, glucose, and renal function frequently; maximum potassium infusion rate: 5 mEq/hour (6.7 mL/hour). |
| 1st trimester | Potassium chloride, dextrose, and sodium chloride are essential nutrients. Use during the first trimester is generally considered safe when clinically indicated for fluid and electrolyte maintenance. Excessive potassium can cause hyperkalemia, but standard doses are not associated with teratogenicity. |
| 2nd trimester | Second trimester use is safe for maternal hydration and electrolyte balance. Monitor serum potassium to avoid hyperkalemia. |
| 3rd trimester | Third trimester use is safe for correction of electrolyte imbalances. High doses of dextrose may cause maternal hyperglycemia and neonatal hypoglycemia; monitor blood glucose. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium, dextrose, and sodium chloride readily cross the placenta by passive diffusion and facilitate placental transport. Clinically, there is no evidence of fetal harm when used appropriately. |
| Breastfeeding | Potassium, dextrose, and sodium chloride are normal constituents of breast milk and maternal plasma. Use during breastfeeding is considered safe at recommended doses. The amounts excreted into milk are unlikely to affect the nursing infant. |
| Lactation Rating | L1 (Compatible) |
| Teratogenic Risk | Pregnancy category C. Potassium chloride is an essential electrolyte; potassium depletion in pregnancy is associated with fetal growth restriction and preterm labor. No specific teratogenicity from potassium chloride itself. Dextrose may cause maternal hyperglycemia with fetal hyperinsulinemia and macrosomia if uncontrolled. Sodium chloride in typical IV fluids is safe at standard doses; excessive sodium may contribute to maternal edema or hypertension. |
| Fetal Monitoring | Monitor maternal serum potassium, sodium, glucose, and renal function. Assess fluid balance (input/output, edema, blood pressure). Fetal monitoring indicated if maternal hyperglycemia or electrolyte abnormalities occur. Continuous fetal heart rate monitoring in cases of preterm labor or preeclampsia. |
| Fertility Effects | No known adverse effects on fertility at therapeutic doses. Electrolyte disturbances (hypokalemia) may impair ovulation; correction of deficiencies may restore fertility. |
■ FDA Black Box Warning
Concentrated potassium chloride solutions must be diluted before use to avoid fatal hyperkalemia. Rapid infusion may cause cardiac arrest.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaHypernatremiaHyperglycemia (if dextrose is contraindicated)Severe renal impairment with oliguria or anuriaSevere dehydrationEdema with sodium retention
| Precautions | Monitor serum potassium and glucose levels. Use with caution in patients with renal impairment, cardiac disease, or hyperkalemia. May cause volume overload, hypernatremia, or hyperglycemia. Do not administer unless solution is clear and container is intact. |
| Food/Dietary | No direct food interactions. Patients on potassium supplements or potassium-sparing diuretics should avoid high-potassium foods (bananas, oranges, potatoes, spinach) due to risk of hyperkalemia. Dextrose content may affect blood glucose; diabetic patients should adhere to their meal plan and monitor glucose levels. |
| Clinical Pearls | Potassium chloride 0.075% (0.1 mEq/mL) in dextrose 10% and sodium chloride 0.9% provides maintenance fluids with potassium supplementation. Use with caution in renal impairment (risk of hyperkalemia). Monitor serum potassium and glucose levels, especially in diabetic patients. Do not administer if solution is cloudy or contains particulates. Rate of infusion should not exceed 10-20 mEq/hour potassium. |
| Patient Advice | This medication is given intravenously to provide fluids, sugar, and electrolytes. · Tell your healthcare provider if you have kidney problems, diabetes, or are on a salt-restricted diet. · Report symptoms of high potassium (muscle weakness, irregular heartbeat) or high blood sugar (increased thirst, frequent urination). · Do not stop or change the infusion rate without consulting your healthcare provider. |
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