POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride replenishes potassium stores; potassium is the major intracellular cation and is essential for nerve conduction, muscle contraction, and acid-base balance. Dextrose provides calories and sodium chloride supplies sodium and chloride ions to maintain electrolyte balance.
| Metabolism | Potassium is primarily excreted renally; dextrose undergoes glycolysis and oxidative metabolism; sodium chloride is renally excreted. |
| Excretion | Renal excretion: >90% of potassium is eliminated via kidneys; <10% fecal. Dextrose and sodium are primarily metabolized or renally excreted. |
| Half-life | Potassium: not applicable (homeostatic regulation); dextrose and sodium: endogenous, no elimination half-life. For exogenous potassium, distribution half-life ~1-1.5 h. |
| Protein binding | Potassium: essentially zero; dextrose: not bound; sodium: negligible binding. |
| Volume of Distribution | Potassium: ~0.5 L/kg (body weight), representing total body water; sodium: ~0.2 L/kg (extracellular fluid); dextrose: ~0.2 L/kg (extracellular fluid). |
| Bioavailability | Intravenous: 100%; oral: 100% (for potassium, if no malabsorption; dextrose and sodium fully absorbed). |
| Onset of Action | Intravenous: immediate (within seconds to minutes) for plasma potassium elevation; oral: 30–60 minutes. |
| Duration of Action | Intravenous: 1–2 hours after infusion cessation; oral: 4–6 hours, depending on potassium load and renal function. |
| Molecular Weight | 74.55 |
IV infusion: 1 L contains 20 mEq K+, 50 g dextrose, and 77 mEq Na+ and Cl- each. Adjust rate based on potassium deficit and serum potassium. Typical adult rate: 10-20 mEq/hour via peripheral IV, not to exceed 40 mEq/hour or 200 mEq/day.
| Dosage form | INJECTABLE |
| Renal impairment | GFR >50 mL/min: no adjustment. GFR 30-50: reduce rate by 50% or use with caution. GFR 10-29: avoid use or give with extreme caution, monitor ECG and serum K+. GFR <10: contraindicated. |
| Liver impairment | Child-Pugh A: no adjustment. Child-Pugh B: use with caution, monitor serum K+ closely. Child-Pugh C: contraindicated due to risk of hyperkalemia. |
| Pediatric use | IV infusion: 0.5-1 mEq/kg/dose, max 20 mEq per dose, given over 1-2 hours. Alternatively, 0.1-0.2 mEq/kg/hour. Max infusion rate: 0.5 mEq/kg/hour. Dextrose concentration should be monitored to avoid hypoglycemia. |
| Geriatric use | Start at lower infusion rates (10-15 mEq/hour) due to reduced renal function. Monitor serum potassium and renal function frequently. Consider maximum daily dose of 100 mEq. |
| 1st trimester | Potassium chloride is essential for normal cellular function and is generally considered safe at therapeutic doses. However, excessive potassium supplementation may lead to hyperkalemia, which can be harmful to the fetus. Use with caution and monitor serum potassium levels. |
| 2nd trimester | Similar to first trimester; maintain normal potassium balance. Avoid excessive doses to prevent maternal hyperkalemia, which can affect fetal cardiac function. |
| 3rd trimester | Potassium chloride is commonly used in intravenous fluids during labor and delivery. No known teratogenic effects. Monitor for hyperkalemia, which can cause maternal cardiac arrhythmias and fetal distress. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium is actively transported across the placenta to maintain fetal homeostasis. The placenta regulates potassium transfer; maternal hyperkalemia can lead to increased fetal potassium levels. No significant transplacental passage of potassium chloride at therapeutic doses; however, large intravenous doses may cause transient fetal hyperkalemia. |
| Breastfeeding | Potassium is a normal component of breast milk and is essential for infant growth. Intravenous potassium chloride at therapeutic doses is compatible with breastfeeding. The amount of potassium transferred into milk is negligible and unlikely to affect the infant. However, monitor maternal potassium levels to avoid hyperkalemia. |
| Lactation Rating | L1 |
| Teratogenic Risk | Potassium chloride and dextrose are pregnancy category C. No adequate studies in pregnant women. Potassium chloride at therapeutic doses is unlikely to cause fetal harm. Dextrose is a normal constituent of fetal blood. Sodium chloride at physiologic concentrations is safe. However, maternal electrolyte imbalances could affect fetal homeostasis. First trimester: Theoretical risk of teratogenicity from electrolyte disturbances but no evidence with IV infusion. Second/third trimester: Risk of neonatal hypoglycemia or electrolyte abnormalities if maternal levels are abnormal. Use only if clearly needed. |
| Fetal Monitoring | Monitor maternal serum potassium, sodium, chloride, glucose, and renal function. Assess for signs of fluid overload (edema, hypertension). Fetal monitoring if maternal electrolyte disturbances occur. In high-risk pregnancies, consider intermittent fetal heart rate monitoring. |
| Fertility Effects | No known adverse effects on fertility from therapeutic use. Electrolyte disturbances could theoretically affect gametogenesis but not reported with this combination. |
■ FDA Black Box Warning
Concentrated potassium solutions (e.g., >40 mEq/L) are for intravenous use only and must be diluted and administered slowly to avoid fatal hyperkalemia or cardiac arrest. Do not administer undiluted.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguria or anuriaAddison's disease (untreated)Acute dehydrationConcurrent use of potassium-sparing diuretics or ACE inhibitors (relative, but absolute if potassium levels exceed upper limit of normal)Cellular breakdown disorders (e.g., severe hemolytic reactions, rhabdomyolysis) to prevent exacerbation of hyperkalemia
| Precautions | Monitor serum potassium levels frequently; risk of hyperkalemia especially in renal impairment or with potassium-sparing diuretics., Avoid rapid infusion to prevent hyperkalemia-induced cardiac arrhythmias., Use with caution in patients with heart failure, severe renal insufficiency, or conditions predisposing to hyperkalemia., Intravenous administration may cause phlebitis or extravasation injury. |
| Food/Dietary | Avoid excessive intake of potassium-rich foods (e.g., bananas, oranges, potatoes, spinach, avocados) and potassium-containing salt substitutes, as this may increase risk of hyperkalemia. |
| Clinical Pearls | Use with caution in patients with renal impairment, heart failure, or adrenal insufficiency due to risk of hyperkalemia. Monitor serum potassium levels regularly during infusion. Avoid use in patients with hyperkalemia or severe metabolic acidosis. This solution is isotonic and provides maintenance electrolytes and calories; adjust rate based on fluid and electrolyte status. Incompatible with amphotericin B, cefepime, and sodium bicarbonate in solution. |
| Patient Advice | Inform your healthcare provider if you have kidney problems, heart disease, or are taking potassium-sparing diuretics or ACE inhibitors. · Report any symptoms of high potassium such as muscle weakness, numbness, tingling, or irregular heartbeat. · This medication is given intravenously; do not adjust the infusion rate yourself. · Avoid potassium-containing salt substitutes or potassium supplements unless directed by your doctor. · Inform your provider if you are pregnant or breastfeeding. |
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