POTASSIUM CHLORIDE 0.22% IN DEXTROSE 10% 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 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. |
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 | 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 | Excreted in breast milk in small amounts; M/P ratio not established. Compatible with breastfeeding at recommended doses. |
| Teratogenic Risk | Potassium chloride and dextrose are not teratogenic. Sodium chloride is physiological. No fetal risk identified in any trimester. |
■ 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 |
Hyperkalemia, severe renal impairment with oliguria, anuria, or azotemia, untreated Addison's disease, hyperglycemia, hypersensitivity to any component, conditions where administration of sodium and chloride is detrimental (e.g., hypernatremia, fluid overload).
| 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. |
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| 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. |