POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions essential for nerve impulse transmission, muscle contraction, and acid-base balance. Dextrose supplies glucose for cellular energy. Sodium chloride restores sodium and chloride ions for fluid and electrolyte balance.
| Metabolism | Potassium is not significantly metabolized. Dextrose undergoes glycolysis and oxidative phosphorylation. Sodium and chloride are excreted unchanged primarily by kidneys. |
| Excretion | Potassium: primarily renal (>90% as K+), with minimal biliary/fecal elimination (<2%). Dextrose and sodium chloride are metabolized or excreted renally. |
| Half-life | Potassium: not applicable as a terminal half-life; distribution and elimination follow body potassium homeostasis. Dextrose and sodium chloride are rapidly distributed and eliminated with half-lives of minutes to hours. |
| Protein binding | Potassium: negligible (<2% bound); dextrose: not bound; sodium: minimally bound (<10% loosely bound to proteins). |
| Volume of Distribution | Potassium: approximately 0.5-0.7 L/kg, reflecting distribution primarily in intracellular fluid; dextrose: ~0.2 L/kg (extracellular); sodium: ~0.15-0.3 L/kg (extracellular). |
| Bioavailability | Intravenous: 100% for all components; oral potassium: ~90% absorbed; not applicable for dextrose and sodium chloride via oral route. |
| Onset of Action | Intravenous: immediate (within seconds to minutes) for electrolyte effects; clinical effect on serum potassium levels occurs within minutes to hours depending on dose and infusion rate. |
| Duration of Action | Duration depends on total dose and patient's potassium balance; effects on serum potassium persist for hours after infusion ends, with renal elimination ongoing. |
| Molecular Weight | 74.55 |
Intravenous infusion, rate determined by serum electrolyte levels and fluid requirements; typical adult dose: 1 mL/kg/hour, providing potassium at 0.11 g (1.5 mEq) per 100 mL, dextrose 5 g per 100 mL, and sodium chloride 0.33 g per 100 mL.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min). For moderate impairment (GFR 30-50 mL/min), use with extreme caution, reduce infusion rate, and monitor serum potassium closely. |
| Liver impairment | No specific adjustment required; however, monitor for fluid and electrolyte imbalances in advanced cirrhosis (Child-Pugh C) due to risk of ascites and hepatic encephalopathy. |
| Pediatric use | Weight-based dosing: 5-10 mL/kg/day as maintenance fluid; adjust potassium content to 0.5-1 mEq/kg/day depending on serum potassium levels. |
| Geriatric use | Use lower initial infusion rates due to decreased renal function; monitor renal function and serum potassium frequently. Typical starting rate: 50-100 mL/hour. |
| 1st trimester | Safe; used as electrolyte replenisher; no known teratogenicity. |
| 2nd trimester | Safe; monitor for hyperkalemia in maternal conditions. |
| 3rd trimester | Safe; avoid if severe preeclampsia or renal impairment. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium and chloride cross placenta but are regulated by fetal homeostasis; dextrose crosses freely. |
| Breastfeeding | Potassium and chloride are normal breast milk constituents. Dextrose and sodium chloride are safe. Use with caution only if severe electrolyte imbalances in mother require therapy. |
| Lactation Rating | L1 |
| Teratogenic Risk | Potassium chloride is an essential electrolyte and not teratogenic at physiologic levels. No increased risk of fetal malformations has been reported. Intravenous administration during pregnancy should be guided by maternal electrolyte needs; excessive potassium may cause maternal cardiac arrhythmias, potentially affecting fetal oxygenation. |
| Fetal Monitoring | Monitor maternal serum potassium levels, cardiac rhythm, and urine output. In pregnancy, fetal heart rate monitoring may be indicated if maternal electrolyte imbalances are severe or if rapid infusion occurs. |
| Fertility Effects | No known effects on fertility. Potassium is essential for cellular function; deficiency or excess may indirectly affect reproductive function, but no direct impact on fertility has been documented. |
■ FDA Black Box Warning
Concentrated potassium solutions must be diluted before administration. Rapid infusion may cause fatal hyperkalemia and cardiac arrest.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairmentAddison's diseaseAcute dehydrationConcurrent potassium-sparing diuretics
| Precautions | Monitor serum potassium, sodium, glucose, and renal function., Use with caution in patients with cardiac disease, renal impairment, or conditions predisposing to hyperkalemia., Avoid in patients with hyperkalemia, oliguria, or anuria., Dextrose solutions may cause hyperglycemia; use cautiously in diabetic patients. |
| Food/Dietary | No specific food interactions. Patients on potassium supplements should avoid high-potassium foods (e.g., bananas, oranges, potatoes) without medical advice to prevent hyperkalemia. |
| Clinical Pearls | This combination solution is used for maintenance fluid and electrolyte replacement. Monitor serum potassium and glucose levels, especially in patients with renal impairment or diabetes. Infusion rate should not exceed 20 mEq/hour of potassium due to risk of cardiac arrhythmias. Do not administer if solution is discolored or contains precipitate. Use with caution in patients receiving potassium-sparing diuretics or ACE inhibitors. |
| Patient Advice | Report any pain, redness, or swelling at the infusion site immediately. · Inform your healthcare provider if you have a history of kidney problems, heart disease, or diabetes. · Do not adjust the infusion rate yourself. · Tell your doctor about all medications you are taking, especially diuretics or blood pressure medicines. · This solution contains dextrose; if you have diabetes, your blood sugar may need monitoring. |
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