POTASSIUM CHLORIDE 0.11% 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 chloride replaces potassium ions lost from the body, maintaining cellular membrane potential and acid-base balance. Dextrose 5% provides a source of calories and water for hydration. Sodium chloride 0.9% replenishes sodium and chloride ions, restoring extracellular fluid volume and osmolarity.
| Metabolism | Potassium is primarily excreted unchanged by the kidneys. Dextrose is metabolized via glycolysis and the citric acid cycle to carbon dioxide and water, with endogenous insulin facilitating cellular uptake. Sodium and chloride are not metabolized but are excreted mainly by the kidneys. |
| Excretion | Potassium is primarily excreted renally (90%) via glomerular filtration and distal tubular secretion; about 10% is eliminated in feces via gastrointestinal secretion. Dextrose is fully metabolized to CO2 and water, while sodium and chloride are renally excreted with reabsorption regulated by renal function. |
| Half-life | Potassium has a half-life of approximately 12-24 hours in healthy individuals, reflecting redistribution and renal elimination; prolonged in renal impairment. Dextrose has a half-life of <30 minutes due to rapid cellular uptake and metabolism. |
| Protein binding | Potassium: approximately 0% bound (free ion); no clinically relevant binding to albumin. Dextrose: not bound. Sodium and chloride: free ions, no binding. |
| Volume of Distribution | Potassium: 0.5-0.6 L/kg, approximating total body water; Vd increases in hypokalemia. Dextrose: 0.2 L/kg (extracellular) initially, then distributes to total body water. Sodium: 0.6-0.7 L/kg; chloride similar. |
| Bioavailability | Intravenous: 100% bioavailable for all components. Not administered orally in this formulation. |
| Onset of Action | Intravenous: Immediate onset (within seconds to minutes) for electrolyte effects; dextrose effect on blood glucose occurs within 5-10 minutes. |
| Duration of Action | Electrolyte effects persist for 4-6 hours post-infusion depending on renal function and distribution; dextrose effect lasts 1-2 hours due to rapid clearance. |
Intravenous infusion at a rate of 10 mEq potassium chloride per hour, maximum 40 mEq per day, as needed to correct hypokalemia. Product is a fixed combination; typical administration is 1-2 L per day of the solution.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min). In moderate impairment (GFR 30-50 mL/min), reduce dose by 25-50% and monitor serum potassium frequently. Avoid in oliguria or anuria. |
| Liver impairment | No specific adjustments for hepatic impairment; however, use caution in severe hepatic disease due to risk of fluid and electrolyte imbalances. |
| Pediatric use | Weight-based: 0.5-1 mEq/kg per dose, administered as diluted solution at a rate not exceeding 0.5 mEq/kg per hour. Maximum daily dose 2 mEq/kg. Monitor serum potassium closely. |
| Geriatric use | Start at lower end of dosing range; maximum 40 mEq per day. Consider reduced renal function; monitor serum potassium and renal function regularly. Avoid excessive fluid volume due to risk of fluid overload. |
| 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, dextrose, and sodium are normal constituents of breast milk. No specific M/P ratio available; infusion of these electrolytes does not significantly alter milk composition. Compatible with breastfeeding with usual monitoring. |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride are physiological electrolytes and nutrients. No teratogenic effects are expected at standard therapeutic doses. However, hyperkalemia or electrolyte imbalances may cause fetal arrhythmias or metabolic disturbances. First trimester: No known specific risk. Second and third trimesters: Risk only if maternal electrolyte levels are markedly abnormal. |
■ FDA Black Box Warning
Potassium chloride injection concentrate should be diluted before use to avoid potentially fatal hyperkalemia. Risk of cardiac arrest if administered improperly.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Hypersensitivity to any component","Severe renal impairment with oliguria or azotemia","Addison's disease","Acute dehydration","Heat cramps","Concurrent use of potassium-sparing diuretics or ACE inhibitors (relative)"]
| Precautions | ["Monitor serum potassium, glucose, and electrolytes frequently","Use with caution in patients with renal impairment, heart disease, or conditions predisposing to hyperkalemia","Administer via central line if concentration > 40 mEq/L","Risk of hyperglycemia in patients with diabetes mellitus","Assess for signs of fluid overload"] |
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| Fetal Monitoring | Monitor maternal serum electrolytes (potassium, sodium, glucose), fluid balance, and renal function. Fetal heart rate monitoring if maternal electrolyte disturbances occur or if administered for conditions like preeclampsia. |
| Fertility Effects | No known effects on fertility. Electrolyte and glucose solutions are not expected to impair reproductive function. |