POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride replaces potassium ions, essential for maintaining cellular membrane potential, acid-base balance, and nerve conduction. Dextrose provides a source of calories and may increase serum osmolality. Sodium chloride restores sodium and chloride ions, correcting extracellular fluid deficits.
| Metabolism | Potassium is primarily excreted unchanged by the kidneys; dextrose is metabolized via glycolysis; sodium and chloride undergo renal reabsorption and excretion. |
| Excretion | Renal excretion of potassium is >90%, with negligible biliary or fecal elimination. Excretion is primarily via kidneys, with potassium filtered, reabsorbed, and secreted by renal tubules. |
| Half-life | Not applicable as a terminal elimination half-life; potassium is a physiological ion. Endogenous regulation maintains serum levels. In context, excess potassium is cleared with a functional half-life of about 6-8 hours in patients with normal renal function. |
| Protein binding | 0% bound to plasma proteins; potassium exists as free ion. |
| Volume of Distribution | 0.2-0.5 L/kg; primarily extracellular distribution, with 98% of total body potassium intracellular. Vd reflects rapid equilibration with interstitial fluid. |
| Bioavailability | Intravenous: 100% (complete). Not available orally via this formulation. |
| Onset of Action | Intravenous: rapid, within minutes for electrolyte repletion; effect on serum potassium levels is immediate upon infusion. |
| Duration of Action | Intravenous: duration depends on infusion rate and renal function; typically effects last hours to days as potassium is redistributed and excreted. |
| Molecular Weight | 74.55 (for potassium chloride); the solution is a mixture, but the active electrolyte potassium chloride has MW 74.55 Da. |
Intravenous infusion; typical adult dose is 1 to 2 L per day, providing 20-40 mEq potassium chloride (as 0.15% KCl), 50-100 g dextrose, and 154-308 mEq sodium chloride, adjusted based on serum electrolytes and fluid status.
| Dosage form | INJECTABLE |
| Renal impairment | Use with caution; for GFR 30-50 mL/min, reduce potassium chloride to 0.1% or less; for GFR <30 mL/min, avoid potassium chloride due to risk of hyperkalemia. Monitor serum potassium closely. |
| Liver impairment | No specific dose adjustment for hepatic impairment; however, in severe hepatic disease (Child-Pugh C), monitor for fluid overload and electrolyte disturbances. |
| Pediatric use | Weight-based: Potassium chloride 0.5-1 mEq/kg/day, dextrose 5-10 mg/kg/min, sodium chloride 2-4 mEq/kg/day, administered as continuous IV infusion at a rate not exceeding 0.5 mEq/kg/hour for potassium. |
| Geriatric use | Start at lower end of dosing range; monitor renal function and serum electrolytes frequently due to age-related decline in GFR and increased sensitivity to fluid and electrolyte shifts. |
| 1st trimester | Potassium chloride 0.15% in dextrose 5% and sodium chloride 0.9% is generally considered safe during pregnancy when used as a maintenance solution. No increased risk of major malformations has been reported. However, use only if clearly needed and monitor serum electrolytes, as fluid and electrolyte imbalances may affect pregnancy. |
| 2nd trimester | Safe for use during pregnancy when indicated. Monitor for electrolyte disturbances and fluid overload, which may affect maternal and fetal health. Use with caution in preeclampsia or hypertension. |
| 3rd trimester | Use with caution in the third trimester, particularly near term, due to potential effects on fluid balance and maternal blood pressure. During labor and delivery, excessive administration may cause hyperkalemia in the mother, which can affect fetal heart rate. Monitor maternal serum potassium and fetal well-being. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium, dextrose, and sodium chloride cross the placenta by passive diffusion and active transport. Potassium levels in fetal plasma are regulated by the placenta. Maternal administration of potassium can increase fetal potassium levels, especially in cases of maternal hyperkalemia. Dextrose crosses readily and may cause fetal hyperglycemia and insulin release. |
| Breastfeeding | Potassium chloride and components (dextrose, sodium chloride) are present in breast milk at low concentrations. No adverse effects on the nursing infant are expected with usual doses. However, maternal electrolyte balance should be maintained; excessive potassium intake may theoretically affect infant serum potassium. Use only if clearly indicated. |
| Lactation Rating | L1 |
| Teratogenic Risk | No evidence of teratogenicity in animal studies or human case reports. Potassium chloride, dextrose, and sodium chloride are physiologic components at standard concentrations. Not associated with major malformations. Avoid hyperkalemia which may cause fetal arrhythmias. |
| Fetal Monitoring | Monitor maternal serum potassium, glucose, osmolality, and fluid balance. Fetal heart rate monitoring if maternal hyperglycemia or electrolyte disturbances occur. Assess for signs of fluid overload. |
| Fertility Effects | No known effects on fertility. Components are physiologic and not associated with reproductive toxicity. |
■ FDA Black Box Warning
Concentrated potassium chloride solutions are fatal if given undiluted. Must be diluted and administered slowly via IV infusion.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment (e.g., oliguria, anuria, acute renal failure)Hypertonic dehydrationHyperchloremiaHypernatremiaConcomitant use with potassium-sparing diuretics without close monitoringAddison's disease (untreated)
| Precautions | Monitor serum potassium, glucose, and electrolytes frequently. Use with caution in renal impairment, cardiac disease, hyperkalemia, metabolic alkalosis, and conditions predisposing to hyperkalemia. Do not administer if solution contains particulate matter or if container is damaged. |
| Food/Dietary | No specific food interactions. Dietary potassium intake should be monitored in patients with hyperkalemia risk. |
| Clinical Pearls | This combination solution provides maintenance hydration with potassium supplementation. Monitor serum potassium closely in renal impairment, patients on ACE inhibitors/ARBs, or K-sparing diuretics. Contraindicated in hyperkalemia. Infusion rate should not exceed 10 mEq/hour potassium. Use with caution in heart failure due to sodium content. |
| Patient Advice | This intravenous fluid contains potassium, sodium, and dextrose. · Tell your doctor if you have kidney problems, heart disease, or are taking certain blood pressure medications. · Symptoms of too much potassium include muscle weakness, irregular heartbeat, or confusion. · You may experience discomfort at the IV insertion site. |
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