POTASSIUM CHLORIDE 0.15% 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, 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. |
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 | 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 | All components are endogenous and present in breast milk. No known adverse effects at therapeutic doses. M/P ratio not applicable as these are electrolytes and sugar. Compatible with breastfeeding. |
| 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. |
■ 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 |
Hyperkalemia, severe renal impairment with oliguria or anuria, untreated Addison's disease, adynamia episodica hereditaria, acute dehydration, heat cramps, patients receiving potassium-sparing diuretics.
| 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. |
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| 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. |