POTASSIUM CHLORIDE 0.22% IN DEXTROSE 10% 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 intracellular tonicity, nerve impulse conduction, muscle contraction, and acid-base balance. Dextrose provides caloric supplementation and improves electrolyte absorption. Sodium chloride maintains extracellular fluid volume and osmolality.
| Metabolism | Potassium is primarily excreted unchanged by the kidneys; dextrose is metabolized via glycolysis and oxidative phosphorylation; sodium chloride is not metabolized. |
| Excretion | Renal: >90% as potassium ions; tubular reabsorption varies with potassium balance. Fecal: <10%. Biliary: negligible. |
| Half-life | Not applicable; potassium is not eliminated by first-order kinetics. Terminal half-life reflects redistribution and renal excretion; approximately 2-6 hours in normal renal function, but clinically irrelevant due to ongoing homeostatic regulation. |
| Protein binding | Not significantly bound; <5% bound to albumin. |
| Volume of Distribution | Total body water: approximately 0.6 L/kg (range 0.5-0.7 L/kg). In adults: ~42 L for 70 kg individual. |
| Bioavailability | Oral: 90-100% (immediate release); sustained-release: 80-95% (due to incomplete release). Intravenous: 100%. |
| Onset of Action | Intravenous: minutes (immediate effect on serum potassium). Oral: 1-2 hours for increase in serum concentration. |
| Duration of Action | Intravenous: 2-4 hours for acute infusion; continuous infusion required for sustained effect. Oral: 6-8 hours for sustained-release forms; immediate-release: 2-4 hours. |
| Molecular Weight | 74.55 (Potassium Chloride); see also dextrose 180.16, sodium chloride 58.44 |
Intravenous infusion; adult: 1000 mL to 2000 mL per 24 hours, providing 2.2 mEq potassium per 100 mL, 10 g dextrose per 100 mL, and 15.4 mEq sodium per 100 mL; rate of infusion tailored to fluid and electrolyte needs, typically 1-2 mL/kg/hr.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (eGFR <30 mL/min/1.73 m²) due to risk of hyperkalemia; for moderate impairment (eGFR 30-59 mL/min/1.73 m²), use with caution and monitor serum potassium; dose reduction may be required; no specific GFR-based dosing formula established. |
| Liver impairment | No specific adjustments for Child-Pugh class A or B; for severe hepatic impairment (Child-Pugh class C), use with caution due to risk of fluid and electrolyte imbalances; monitor serum potassium and adjust infusion rate; no predefined dose reduction. |
| Pediatric use | Intravenous infusion; weight-based: initial dose typically 5-10 mL/kg over 1-2 hours, with subsequent rates of 0.5-1 mL/kg/hr; maximum infusion rate not to exceed 10 mL/kg/hr; adjust potassium, dextrose, and sodium based on serum electrolyte levels and clinical status. |
| Geriatric use | Lower initial infusion rates (e.g., 0.5-1 mL/kg/hr) due to decreased renal function and increased risk of fluid overload; monitor serum potassium, glucose, and sodium; consider lower total daily volume; avoid rapid infusion. |
| 1st trimester | Potassium chloride and dextrose are considered safe when used as electrolyte and nutritional supplementation in pregnant women. However, caution is advised as fluid and electrolyte balance must be closely monitored, especially in conditions like preeclampsia or gestational diabetes. |
| 2nd trimester | Generally safe with appropriate monitoring. Avoid large volumes of dextrose that may cause hyperglycemia in the mother or fetus. |
| 3rd trimester | Safe with careful monitoring of maternal electrolytes and glucose. Potassium chloride may affect uterine tone; use only if clearly needed. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium crosses the placenta by active transport and passive diffusion, maintaining fetal serum levels. Dextrose readily crosses the placenta. Sodium and chloride also cross, with fetal levels regulated by maternal levels. |
| Breastfeeding | Potassium and chloride are normal constituents of breast milk. Dextrose and sodium chloride are also safe. However, consider the maternal condition requiring this combination. Monitor infant for side effects if large volumes are administered. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Potassium chloride and dextrose are not teratogenic. Sodium chloride is physiological. No fetal risk identified in any trimester. |
| Fetal Monitoring | Monitor serum electrolytes, glucose, fluid balance, and renal function; assess for signs of hyperkalemia or fluid overload. |
| Fertility Effects | No known effects on fertility. |
■ FDA Black Box Warning
Potassium chloride concentrate injections must be diluted before use; administration of undiluted potassium chloride may cause fatal cardiac arrest.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaHypernatremiaSevere dehydration with hypernatremiaPatients with intracranial or spinal hemorrhageSevere renal impairment with oliguria or anuriaHyperglycemia with dextrose contraindication (e.g., diabetic ketoacidosis without insulin)
| Precautions | Monitor serum potassium, glucose, and sodium levels; risk of hyperkalemia in renal impairment; solutions containing dextrose may cause hyperglycemia; use with caution in patients with heart failure, renal failure, or adrenal insufficiency. |
| Food/Dietary | No specific food interactions. However, dietary potassium intake should be considered; patients should avoid excessive potassium-rich foods (e.g., bananas, oranges, potatoes, spinach) unless supervised. |
| Clinical Pearls | This solution provides potassium supplementation with dextrose and sodium chloride. Monitor for hyperkalemia in renal impairment or with ACE inhibitors/ARBs. The 10% dextrose may cause hyperglycemia; use with caution in diabetes. Rapid infusion can cause phlebitis; consider central line for high osmolarity. Check serum potassium before and during infusion. Not for cardiac arrest or severe hyperkalemia. |
| Patient Advice | This intravenous fluid contains potassium, sugar, and salt. Tell your doctor if you have kidney problems, diabetes, or heart conditions. · You may experience discomfort at the IV site; report pain, redness, or swelling. · This solution is for hospital use only; do not adjust the infusion rate. · If you feel muscle weakness, tingling, or irregular heartbeat, notify your nurse immediately. |
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