POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions for cellular electrolyte balance, essential for nerve conduction, muscle contraction, and acid-base homeostasis. Dextrose acts as a caloric source, and sodium chloride provides sodium and chloride ions for fluid and electrolyte balance.
| Metabolism | Potassium is primarily excreted unchanged by the kidneys. Dextrose is metabolized via glycolysis to carbon dioxide and water, providing energy. Sodium and chloride are excreted mainly via kidneys. |
| Excretion | Potassium is primarily excreted renally (approximately 90%), with about 10% eliminated via feces. Under normal conditions, the kidneys excrete 40-120 mEq/day of potassium, with excretion closely matched to intake. Biliary excretion is negligible. |
| Half-life | The terminal elimination half-life of potassium is not well-defined as a single value due to rapid distribution kinetics. However, whole-body turnover half-life is approximately 12-24 hours. Clinically, redistribution half-life from plasma to cells is about 1-2 hours, while total body elimination depends on renal function. |
| Protein binding | Potassium is not significantly bound to plasma proteins; protein binding is approximately 0%. It exists as free ions. |
| Volume of Distribution | Volume of distribution for potassium is 0.5-0.7 L/kg (average 0.6 L/kg), reflecting total body water. Clinical meaning: Potassium distributes mainly in the intracellular space (98% of total body potassium) with only 2% in extracellular fluid; thus, changes in serum levels poorly reflect total body stores. The Vd is used to calculate loading doses for replacement therapy. |
| Bioavailability | Oral: Potassium chloride is well absorbed from the gastrointestinal tract with an oral bioavailability of approximately 90-100%. Intravenous: 100% bioavailability. |
| Onset of Action | Intravenous administration: Onset of action is immediate (within seconds to minutes) as potassium directly affects myocardial membrane potential. Oral administration: Onset of action for correction of hypokalemia is typically 1-2 hours, but full effect may require days of therapy. |
| Duration of Action | Continuous intravenous infusion: Effect persists only during infusion and for a short time after cessation (minutes to hours) due to rapid redistribution and renal excretion. Oral: The effect on serum potassium lasts for the dosing interval (e.g., 6-24 hours depending on formulation). Clinical note: Potassium is not suitable for acute replacement via peripheral IV due to risk of hyperkalemia; infusion rates are typically limited to 10-20 mEq/hour. |
Intravenous infusion. Dose determined by electrolyte needs; typical maintenance: 1000-2000 mL/day (providing 20-40 mEq potassium, 50-100 g dextrose, and 77-154 mEq sodium). Rate not to exceed 10 mEq/hour potassium.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min) unless carefully monitored. For GFR 30-50 mL/min: reduce dose by 50% and monitor potassium levels. For GFR >50 mL/min: no adjustment typically needed. |
| Liver impairment | No specific adjustment for Child-Pugh class A or B. For Class C (severe hepatic impairment): use with caution due to risk of electrolyte disturbances; monitor potassium and glucose levels. |
| Pediatric use | Dose based on weight and electrolyte requirements. Typical starting infusion: 0.5-1 mEq/kg/day potassium (as part of fluid). Rate not to exceed 0.5 mEq/kg/hour. Monitor serum potassium and glucose. |
| Geriatric use | Initiate at lower end of dosing range due to potential renal function decline. Monitor renal function, serum potassium, and glucose closely. Avoid rapid infusion; maximum rate 10 mEq/hour potassium. |
| 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 is a normal constituent of breast milk. Supplemental potassium chloride is considered compatible with breastfeeding. No M/P ratio available; potassium levels in milk are regulated and unlikely to be affected by maternal supplementation except in overdose. |
| Teratogenic Risk | Potassium chloride is a physiologic ion. No teratogenic effects have been associated with potassium chloride administration at recommended doses. However, hyperkalemia or hypokalemia may adversely affect fetal development. First trimester: no specific risk; second and third trimesters: risk only if maternal electrolyte disturbances occur. |
■ FDA Black Box Warning
Concentrated potassium chloride solutions (e.g., >0.1% KCl) must be diluted before administration to avoid fatal hyperkalemia. This product contains 0.075% KCl and is not concentrated, but caution is still required.
| Common Effects | fluid replacement |
| Serious Effects |
Hyperkalemia, severe renal failure with oliguria or anuria, untreated Addison's disease, concomitant use of potassium-sparing diuretics, acute dehydration, heat cramps, and conditions where potassium administration is contraindicated.
| Precautions | Monitor serum potassium levels to avoid hyperkalemia; use with caution in patients with renal impairment, cardiac disease, or conditions predisposing to hyperkalemia. Administer via compatible intravenous line; do not add medications to the plastic container. Check for air embolism risk. |
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| Fetal Monitoring | Monitor serum potassium, glucose, and electrolytes regularly. Assess maternal renal function. Monitor fetal heart rate and uterine activity if intravenous infusion is given during labor. |
| Fertility Effects | No known adverse effects on fertility at therapeutic doses. Electrolyte disturbances may impair reproductive function, but potassium chloride supplementation does not directly affect fertility. |