POTASSIUM CHLORIDE 0.15% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride dissociates to provide potassium ions, which are essential for maintaining intracellular tonicity, nerve conduction, muscle contraction, and renal function. Dextrose provides calories and is metabolized as a source of energy. Sodium chloride provides sodium and chloride ions, which are major extracellular cations and anions, respectively, contributing to fluid and electrolyte balance.
| Metabolism | Potassium is not metabolized; it is primarily excreted unchanged by the kidneys. Dextrose is metabolized via glycolysis and the citric acid cycle. Sodium and chloride are not metabolized; sodium is excreted mainly by the kidneys. |
| Excretion | Renal: potassium is primarily excreted by the kidneys (90%) with a small amount lost in feces (10%); dextrose and sodium are essentially completely reabsorbed or metabolized. |
| Half-life | The terminal elimination half-life of potassium is 2-3 hours in healthy individuals, but may be prolonged in renal impairment or with high potassium loads. |
| Protein binding | Potassium: essentially unbound (<1%); dextrose and sodium are not protein bound. |
| Volume of Distribution | Potassium: 0.35 L/kg (total body water); dextrose distributes into total body water; sodium distributes into extracellular fluid (0.2 L/kg). |
| Bioavailability | Intravenous: 100% bioavailability; not administered via other routes for systemic effect. |
| Onset of Action | Intravenous: rapid onset of action within minutes to correct hypokalemia; dextrose distribution occurs within minutes, but metabolic effects on glucose may take 15-30 minutes. |
| Duration of Action | Intravenous: effect lasts 2-4 hours depending on infusion rate and patient's potassium balance; dextrose effect sustained during infusion. |
Adult: Intravenous infusion. Rate and volume depend on clinical status. Typical maintenance: 100-200 mL/h. Maximum infusion rate: 0.5-1 mEq/kg/h (potassium).
| Dosage form | INJECTABLE |
| Renal impairment | GFR > 50 mL/min: no adjustment. GFR 10-50 mL/min: reduce by 50% or extend interval. GFR < 10 mL/min: avoid or use with extreme caution, reduce dose by 75%. |
| Liver impairment | No specific adjustment required for Child-Pugh A or B. Child-Pugh C: use with caution, monitor electrolytes closely. |
| Pediatric use | Children: IV infusion based on weight. Typical maintenance: 100 mL/kg/day for first 10 kg, 50 mL/kg/day for next 10 kg, 20 mL/kg/day for each kg >20 kg. Potassium content adjusted to 0.15% (2 mEq/100 mL) but rate limited to 0.5-1 mEq/kg/h. |
| Geriatric use | Elderly: Use lower end of dosing range due to decreased renal function. Monitor serum potassium and renal function closely. Avoid rapid infusion. |
| 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 chloride are endogenous substances excreted in breast milk in low amounts. M/P ratio not established. Considered compatible with breastfeeding if maternal serum levels are within normal range. |
| Teratogenic Risk | Potassium chloride and dextrose at these concentrations are not associated with teratogenicity. Sodium chloride is physiological. However, maternal electrolyte imbalances (hyperkalemia, hypernatremia) may affect fetal homeostasis. No specific trimester risks are documented at standard therapeutic doses. |
■ FDA Black Box Warning
Do not infuse undiluted potassium chloride. High plasma concentrations of potassium may cause hyperkalemia, cardiac arrest, or fatal arrhythmias. Use with caution in patients with renal impairment or conditions predisposing to hyperkalemia.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Severe renal failure with oliguria or anuria","Addison's disease","Acute dehydration","Concomitant use of potassium-sparing diuretics","Crushed or traumatized muscle tissue"]
| Precautions | ["Risk of hyperkalemia, especially in patients with renal impairment, adrenal insufficiency, or massive tissue trauma","Electrocardiographic monitoring recommended if high potassium concentrations are infused","Risk of fluid overload or electrolyte disturbances","Use with caution in patients with heart failure, edema, or conditions requiring sodium restriction","Assess renal function before administration"] |
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| Fetal Monitoring | Monitor maternal serum electrolytes (potassium, sodium, glucose), fluid balance, and renal function. Fetal monitoring (heart rate, growth) if maternal metabolic disturbances occur. |
| Fertility Effects | No known adverse effects on fertility from potassium chloride, dextrose, or sodium chloride at therapeutic doses. |