POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium is the primary intracellular cation, essential for maintaining cell membrane potential, nerve impulse transmission, cardiac contractility, and muscle function. Dextrose provides caloric support, and sodium chloride maintains electrolyte balance.
| Metabolism | Potassium is not metabolized; it is excreted primarily by the kidneys (via glomerular filtration and distal tubular secretion). Dextrose is metabolized to carbon dioxide and water via glycolysis and oxidative phosphorylation. Sodium chloride is excreted renally. |
| Excretion | Renal: >90% of potassium is excreted by the kidneys, with a small portion (approximately 2-5%) eliminated in feces via gastrointestinal secretion. Biliary excretion is negligible. |
| Half-life | Potassium has a biological half-life of approximately 12-24 hours in plasma, but this is not clinically useful due to rapid redistribution and tight homeostatic control. The terminal elimination half-life from total body stores is about 30 days. |
| Protein binding | Potassium is not significantly protein-bound; at physiologic pH, it exists as free ions with no binding to albumin or other plasma proteins. Reported protein binding is <0% (essentially 0%). |
| Volume of Distribution | Potassium has a total body volume of distribution of approximately 0.5-0.6 L/kg (about 35-42 L in a 70 kg adult). This reflects distribution into the extracellular fluid space (approximately 0.25 L/kg) with additional uptake into intracellular compartments (primarily muscle) over hours to days. |
| Bioavailability | Oral: 90-100% (nearly complete absorption from the gastrointestinal tract). Intravenous: 100%. Note: In this formulation, potassium is administered intravenously; oral bioavailability is provided for comparison. |
| Onset of Action | Intravenous: Immediate (within seconds to minutes) after infusion start, as potassium directly affects cardiac and neuromuscular function. Oral: 30-60 minutes for measurable serum potassium increase; full effect may take 2-4 hours. |
| Duration of Action | Intravenous: 4-6 hours after infusion cessation, depending on dose and patient factors; clinical effect on arrhythmias may persist for 2-4 hours. Oral: 6-12 hours for serum potassium elevation, with effects on total body potassium lasting up to 24 hours due to slow redistribution into cells. |
Intravenous infusion; rate and volume determined by electrolyte deficit and fluid requirements. Typical adult dose: 10-20 mEq/h, not to exceed 40 mEq/h or 200 mEq per 24 hours. Concentration: 0.075% KCl (10 mEq per 1000 mL) in D5 0.9% NaCl.
| Dosage form | INJECTABLE |
| Renal impairment | GFR <30 mL/min: use with caution; reduce total daily dose by 25-50% and monitor serum potassium. GFR 30-60 mL/min: consider reduction by 10-25%. GFR >60 mL/min: no adjustment required. |
| Liver impairment | Child-Pugh Class A (5-6 points): no adjustment. Child-Pugh Class B (7-9 points): reduce rate by 25-50% due to risk of hyperkalemia. Child-Pugh Class C (10-15 points): avoid use or reduce dose by 50% with close monitoring. |
| Pediatric use | Intravenous infusion: 0.5-1 mEq/kg per dose, not to exceed 40 mEq/day or 0.5 mEq/kg/h. Administer at a rate no faster than 0.5 mEq/kg/h. For maintenance: 2-3 mEq/kg/day. Adjust based on serum potassium and weight. |
| Geriatric use | Reduce initial dose by 25-50% due to age-related decline in renal function (estimated GFR <60 mL/min). Monitor serum potassium frequently. Maximum infusion rate: 10 mEq/h. Use with caution in patients on RAAS inhibitors or NSAIDs. |
| 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 chloride is a normal constituent of breast milk. No M/P ratio reported; levels correspond to maternal plasma. Compatible with breastfeeding at therapeutic doses. |
| Teratogenic Risk | Potassium chloride at therapeutic doses is not associated with teratogenicity. Dextrose 5% and sodium chloride 0.9% are physiologic and not teratogenic. No known fetal risk in any trimester. However, electrolyte imbalances (hyperkalemia, hypokalemia) may affect fetal cardiac function. |
■ FDA Black Box Warning
None. However, concentrated potassium solutions (>40 mEq/L or >0.2 mEq/mL) require dilution and careful administration due to risk of hyperkalemia and cardiac arrhythmias.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Renal failure with oliguria or anuria","Severe metabolic acidosis","Addison's disease (untreated)","Concurrent use of potassium-sparing diuretics (relative contraindication)","Hyponatremia"]
| Precautions | ["Monitor serum potassium levels closely during therapy","Risk of hyperkalemia, especially in renal impairment","Avoid rapid infusion to prevent hyperkalemia-induced cardiac arrest","Use with caution in patients with heart failure, edema, or conditions causing sodium/water retention","Dextrose may cause hyperglycemia; monitor blood glucose in diabetic patients","Not for use in patients with anuria (contraindicated)"] |
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| Fetal Monitoring | Monitor serum electrolytes (potassium, sodium, glucose), renal function, fluid balance, and fetal heart rate in cases of maternal electrolyte disturbances. |
| Fertility Effects | No known adverse effects on fertility. Electrolyte imbalances may indirectly affect reproductive function. |