POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions for maintenance of electrolyte balance; dextrose provides caloric support; sodium chloride provides sodium and chloride ions for fluid and electrolyte replacement.
| Metabolism | Potassium is not metabolized; dextrose is metabolized via glycolysis and citric acid cycle; sodium and chloride are not metabolized. |
| Excretion | Potassium: primarily renal (>90% excreted by kidneys), with small amounts lost in feces and sweat. Dextrose: metabolized to CO2 and water, minimal renal excretion. Sodium: primarily renal excretion (90-95%), with minor losses in feces and sweat. Chloride: primarily renal excretion (95%). |
| Half-life | Potassium: terminal half-life is approximately 4-6 hours under normal renal function; prolonged in renal impairment. Dextrose: not applicable as it is rapidly metabolized. Sodium: half-life approximately 4-6 hours, dependent on renal function. |
| Protein binding | Potassium: negligible (<1% bound). Dextrose: not bound. Sodium: negligible. Chloride: negligible. |
| Volume of Distribution | Potassium: Vd approximately 0.5-0.6 L/kg, reflecting distribution primarily in extracellular fluid and cellular uptake. Dextrose: Vd equivalent to total body water (~0.6 L/kg). Sodium: Vd approximately 0.5-0.6 L/kg (extracellular fluid). |
| Bioavailability | Intravenous: 100% bioavailability. |
| Onset of Action | Intravenous: correction of hypokalemia begins within minutes; dextrose and sodium effects are immediate. Oral: not applicable as this formulation is for IV use. |
| Duration of Action | Intravenous: potassium effect lasts 4-6 hours post-infusion; dextrose effect is short-lived (30-60 minutes) due to rapid metabolism; sodium effect lasts several hours depending on renal function. |
| Molecular Weight | 74.55 (KCl), 180.16 (dextrose), 58.44 (NaCl) |
Intravenous infusion; adult dose is 1000 mL to 2000 mL per day, providing 20-40 mEq potassium, 50-100 g dextrose, and 77-154 mEq sodium, administered at a rate of 125-200 mL/hour based on clinical status and serum potassium.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR 30-50 mL/min: administer with caution and monitor serum potassium, reduce infusion rate by 25-50%. For GFR 15-29 mL/min: reduce dose by 50-75% and monitor closely. For GFR <15 mL/min: avoid use or use only if absolutely necessary with extreme caution and frequent monitoring. |
| Liver impairment | For Child-Pugh A: no adjustment necessary. For Child-Pugh B: reduce infusion rate by 50% and monitor serum potassium. For Child-Pugh C: avoid use due to risk of hyperkalemia and volume overload. |
| Pediatric use | Intravenous infusion; dose based on weight: 2-4 mEq/kg/day of potassium, 5-10 mg/kg/min of dextrose, and 2-4 mEq/kg/day of sodium. Typical infusion rate: 0.5-1 mEq/kg/hour of potassium. Adjust based on serum electrolytes and glucose. |
| Geriatric use | Start at the lower end of the adult dosing range (1000 mL per day) and titrate slowly. Monitor serum potassium, renal function, and fluid status closely due to increased risk of hyperkalemia and volume overload. |
| 1st trimester | Potassium chloride, dextrose, and sodium chloride are essential nutrients; no fetal risk known in recommended doses. Use only if clearly needed. |
| 2nd trimester | No known teratogenic effects in recommended doses. Use for maternal indication. |
| 3rd trimester | Generally safe in recommended doses. Monitor maternal electrolytes and glucose levels. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium, dextrose, and sodium chloride freely cross the placenta. However, they are maintained within normal physiologic ranges by maternal homeostasis. |
| Breastfeeding | Potassium, dextrose, and sodium chloride are normal components of human milk. No expected adverse effects in breastfed infants with recommended maternal doses. |
| Lactation Rating | Safe |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride in these concentrations are not teratogenic. There is no evidence of fetal harm from electrolyte and glucose solutions administered IV at recommended doses. Dextrose may cause maternal hyperglycemia if infused rapidly, which can lead to fetal hyperinsulinemia and neonatal hypoglycemia, but this is not a direct teratogenic effect. |
| Fetal Monitoring | Monitor maternal serum electrolytes (potassium, sodium, chloride), glucose, renal function, fluid balance, and urine output. Monitor fetal heart rate and uterine contractions if used during labor. Assess for signs of fluid overload (edema, pulmonary congestion) and hyperglycemia. |
| Fertility Effects | No known direct effects on fertility. Electrolyte imbalances and underlying conditions requiring this solution may impact reproductive function, but the solution itself does not impair fertility. |
■ FDA Black Box Warning
Must be diluted before use; concentrated potassium solutions can cause fatal cardiac arrest if administered rapidly or in undiluted form.
| Common Effects | fluid replacement |
| Serious Effects |
Hypersensitivity to any componentClinically significant hyperkalemiaClinically significant hypernatremiaClinically significant hyperglycemiaSevere metabolic acidosisSevere renal impairment with oliguria or anuriaConditions causing sodium or fluid retention (e.g., congestive heart failure, cirrhosis) when exacerbated by IV fluidsAnuria (for potassium administration)
| Precautions | Use caution in patients with severe renal impairment, heart disease, or conditions predisposing to hyperkalemia. Monitor serum potassium and ECG during infusion. Avoid rapid infusion to prevent hyperkalemia. |
| Food/Dietary | Avoid foods high in potassium (e.g., bananas, oranges, potatoes, tomatoes, spinach, avocados) and potassium-containing salt substitutes. Do not consume excessive amounts of sodium-rich foods as this solution already contains sodium chloride. Maintain consistent carbohydrate intake if diabetic, as dextrose may affect blood glucose. |
| Clinical Pearls | Monitor serum potassium and glucose levels frequently; avoid use in patients with hyperkalemia, severe renal impairment, or uncorrected adrenal insufficiency. Administer via central or peripheral line with large bore to prevent phlebitis. Do not administer simultaneously with blood products. Use with caution in patients with cardiac disease or receiving digitalis due to arrhythmia risk. Inspect for particulate matter; do not use if discolored. Rate of infusion should not exceed 10 mEq/hour unless in critical care setting with cardiac monitoring. |
| Patient Advice | Inform your healthcare provider if you have kidney problems, heart disease, or are on any medications, especially potassium-sparing diuretics or ACE inhibitors. · Report any signs of too much potassium, such as muscle weakness, irregular heartbeat, or tingling in hands/feet. · This medication is given intravenously; tell your nurse if you experience pain, redness, or swelling at the IV site. · Do not consume potassium-rich foods or salt substitutes without consulting your doctor, as this may increase risk of hyperkalemia. · Follow your doctor's instructions for monitoring blood tests, including potassium and glucose levels. |
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