POTASSIUM CHLORIDE 0.22% 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.

How it works

Potassium chloride provides potassium ions for maintaining intracellular osmolarity, acid-base balance, and nerve impulse transmission; dextrose is a carbohydrate source for energy metabolism; sodium chloride provides sodium and chloride ions for extracellular fluid balance and osmotic pressure.

What the body does with it

Metabolism	Potassium is primarily excreted unchanged by the kidneys; dextrose is metabolized via glycolysis and the citric acid cycle; sodium and chloride are excreted renally.
Excretion	Potassium: renal (90%), fecal (10%); dextrose: metabolized to CO2 and water; sodium: renal (95%).
Half-life	Potassium: not applicable (regulated by homeostasis); dextrose: <30 minutes; sodium: not applicable.
Protein binding	Potassium: negligible (<5%); dextrose: none; sodium: none.
Volume of Distribution	Potassium: approximately 0.5 L/kg (total body water); dextrose: distributed to total body water; sodium: mainly extracellular fluid (0.2 L/kg).
Bioavailability	Intravenous: 100%.
Onset of Action	Intravenous: immediate (within seconds to minutes).
Duration of Action	Depends on infusion rate and patient's potassium balance; continuous infusion required for sustained effect.

Classification & Brands

Dosing & administration

Intravenous infusion, 1000 mL to 2000 mL per 24 hours, adjusted based on serum potassium, glucose, and sodium levels.

Dosage form	INJECTABLE
Renal impairment	GFR 30-60 mL/min: reduce potassium dose by 50% or monitor serum potassium frequently; GFR <30 mL/min: contraindicated unless serum potassium is low and monitored closely.
Liver impairment	No specific Child-Pugh based adjustment for potassium; dextrose may require monitoring in severe hepatic impairment due to insulin resistance.
Pediatric use	Weight-based: 2-4 mEq/kg/day potassium, with dextrose 5-10 mg/kg/min and sodium 2-4 mEq/kg/day, titrated to serum electrolytes.
Geriatric use	Elderly patients: start at low end of adult range, monitor renal function and serum electrolytes frequently due to age-related decline in renal function.

Use during pregnancy

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	Potassium, dextrose, and sodium chloride are endogenous substances normally present in breast milk. IV administration does not significantly alter milk composition. M/P ratio not applicable as these are normal blood constituents. Compatible with breastfeeding.
Teratogenic Risk	Potassium chloride, dextrose, and sodium chloride are normal physiologic constituents. No teratogenic risk is attributed at therapeutic doses. IV administration during pregnancy is indicated for fluid and electrolyte replacement as needed. No trimester-specific risks identified.

Warnings & precautions

■ FDA Black Box Warning

Potassium chloride injection concentrate must be diluted before use; rapid infusion or undiluted administration can cause fatal hyperkalemia and cardiac arrest.

Side Effect Profile

Common Effects	fluid replacement
Serious Effects

Absolute Contraindications

["Hyperkalemia","Severe renal failure with oliguria or anuria","Untreated Addison's disease","Hyperchloremia","Patients with known hypersensitivity to any component"]

Clinical Precautions

Precautions

["Monitor serum potassium, glucose, and electrolytes frequently during infusion","Use with caution in patients with renal impairment, cardiac disease, or hyperkalemia","Do not administer undiluted or via rapid intravenous infusion","Risk of hyperkalemia, especially with impaired renal function","Risk of fluid overload in patients with heart failure or edema","Risk of hyperglycemia from dextrose content"]

Clinical Tips & Counseling

Drug interactions

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POTASSIUM CHLORIDE 0.22% 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.

How it works

What the body does with it

Metabolism	Potassium is primarily excreted unchanged by the kidneys; dextrose is metabolized via glycolysis and the citric acid cycle; sodium and chloride are excreted renally.
Excretion	Potassium: renal (90%), fecal (10%); dextrose: metabolized to CO2 and water; sodium: renal (95%).
Half-life	Potassium: not applicable (regulated by homeostasis); dextrose: <30 minutes; sodium: not applicable.
Protein binding	Potassium: negligible (<5%); dextrose: none; sodium: none.
Volume of Distribution	Potassium: approximately 0.5 L/kg (total body water); dextrose: distributed to total body water; sodium: mainly extracellular fluid (0.2 L/kg).
Bioavailability	Intravenous: 100%.
Onset of Action	Intravenous: immediate (within seconds to minutes).
Duration of Action	Depends on infusion rate and patient's potassium balance; continuous infusion required for sustained effect.

Classification & Brands

Dosing & administration

Intravenous infusion, 1000 mL to 2000 mL per 24 hours, adjusted based on serum potassium, glucose, and sodium levels.

Dosage form	INJECTABLE
Renal impairment	GFR 30-60 mL/min: reduce potassium dose by 50% or monitor serum potassium frequently; GFR <30 mL/min: contraindicated unless serum potassium is low and monitored closely.
Liver impairment	No specific Child-Pugh based adjustment for potassium; dextrose may require monitoring in severe hepatic impairment due to insulin resistance.
Pediatric use	Weight-based: 2-4 mEq/kg/day potassium, with dextrose 5-10 mg/kg/min and sodium 2-4 mEq/kg/day, titrated to serum electrolytes.
Geriatric use	Elderly patients: start at low end of adult range, monitor renal function and serum electrolytes frequently due to age-related decline in renal function.

Use during pregnancy

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	Potassium, dextrose, and sodium chloride are endogenous substances normally present in breast milk. IV administration does not significantly alter milk composition. M/P ratio not applicable as these are normal blood constituents. Compatible with breastfeeding.
Teratogenic Risk	Potassium chloride, dextrose, and sodium chloride are normal physiologic constituents. No teratogenic risk is attributed at therapeutic doses. IV administration during pregnancy is indicated for fluid and electrolyte replacement as needed. No trimester-specific risks identified.

Warnings & precautions

■ FDA Black Box Warning

Potassium chloride injection concentrate must be diluted before use; rapid infusion or undiluted administration can cause fatal hyperkalemia and cardiac arrest.

Side Effect Profile

Common Effects	fluid replacement
Serious Effects

Absolute Contraindications

["Hyperkalemia","Severe renal failure with oliguria or anuria","Untreated Addison's disease","Hyperchloremia","Patients with known hypersensitivity to any component"]