POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides essential potassium ion for maintaining intracellular osmotic pressure, acid-base balance, and nerve conduction. Dextrose provides calories and increases serum glucose. Sodium chloride supplies sodium and chloride ions to maintain extracellular fluid volume and electrolyte balance.
| Metabolism | Dextrose is metabolized via glycolysis and oxidative phosphorylation. Potassium and sodium are renally excreted; potassium is actively reabsorbed and secreted in distal tubules. |
| Excretion | Renal: >90% as potassium ions, with minor fecal loss (<5%). Biliary excretion is negligible. |
| Half-life | Not applicable as potassium is an endogenous ion; serum half-life reflects redistribution and renal clearance, approximately 6-8 hours in normal renal function. |
| Protein binding | Not significantly protein-bound (<5%); binding to albumin is minimal and clinically irrelevant. |
| Volume of Distribution | Approximately 0.5 L/kg (range 0.4-0.6 L/kg), reflecting distribution primarily in extracellular fluid. |
| Bioavailability | Oral: >90% (well absorbed); intravenous: 100%. |
| Onset of Action | Intravenous: Immediate (within seconds to minutes) for cardiac membrane stabilization; oral: 30-60 minutes for gastrointestinal absorption. |
| Duration of Action | Intravenous: 2-4 hours after infusion cessation; oral: several hours depending on dose and renal function. Continuous replacement may be needed in deficiency states. |
| Molecular Weight | 74.55 |
IV infusion: 10 mEq potassium chloride in 1000 mL D5 0.45% NaCl at a rate not exceeding 10 mEq/hour; maximum 40 mEq/hour with cardiac monitoring. Adult dose typically 20-40 mEq per day, adjusted based on serum potassium.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-50 mL/min: reduce dose by 25%; GFR 10-29 mL/min: reduce dose by 50%; GFR <10 mL/min: avoid or use with extreme caution, maximum 10 mEq/day with frequent monitoring. |
| Liver impairment | Child-Pugh A: no adjustment; Child-Pugh B: reduce dose by 25%; Child-Pugh C: reduce dose by 50% and monitor electrolytes closely. |
| Pediatric use | IV infusion: 0.5-1 mEq/kg/dose, maximum 2 mEq/kg/day; rate not exceeding 0.5 mEq/kg/hour; use with cardiac monitoring. Dilute in appropriate IV fluid. |
| Geriatric use | Initiate at lower end of dosing range (e.g., 10-20 mEq/day), increase slowly; monitor renal function and serum potassium frequently due to age-related decline in renal function. |
| 1st trimester | Safe; potassium and chloride are essential electrolytes; no increased risk of malformations reported with appropriate use. |
| 2nd trimester | Safe; used for electrolyte replenishment; monitor maternal electrolytes to avoid hyperkalemia. |
| 3rd trimester | Safe; may be used for maintenance or replacement; avoid hyperkalemia which can affect uterine tone. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | K+ and Cl- cross placenta by active transport; maternal levels equilibrate with fetal levels. |
| Breastfeeding | Potassium and chloride pass into breast milk but in amounts not expected to cause adverse effects in the infant; compatible with breastfeeding when used at recommended doses. |
| Lactation Rating | L1 - Safe |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride are essential nutrients and electrolytes; no teratogenic effects at physiologic doses. Excess potassium or glucose may cause fetal harm: hyperkalemia can induce fetal bradycardia or arrhythmia; hyperglycemia increases risk of macrosomia, neonatal hypoglycemia. First trimester: no known malformation risk. Second/third trimesters: risk of adverse effects from maternal electrolyte or glucose imbalance. |
| Fetal Monitoring | Monitor maternal serum potassium, sodium, glucose, renal function, ECG for arrhythmias. Fetal heart rate monitoring during labor if maternal hyperkalemia or hyperglycemia. Assess for signs of fluid overload. |
| Fertility Effects | No known direct effects on fertility at physiologic doses. Electrolyte or glucose disturbances may affect reproductive function; correct underlying causes. |
■ FDA Black Box Warning
Potassium chloride injection concentrate must be diluted and used only in patients with severe hypokalemia; undiluted administration can cause fatal cardiac arrhythmias.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguria or anuriaAddison's diseaseAcute dehydrationHeat cramps
| Precautions | Renal impairment, cardiac disease, hyperkalemia, hypernatremia, fluid overload, administration via central line may cause cardiac arrhythmias, monitor serum electrolytes and ECG |
| Food/Dietary | Avoid high-potassium foods (e.g., bananas, oranges, potatoes, tomatoes) unless directed by your healthcare provider. Do not use salt substitutes containing potassium chloride without medical advice. Maintain a consistent dietary intake of potassium. |
| Clinical Pearls | Potassium chloride in dextrose 5% and sodium chloride 0.45% is an isotonic solution used for maintenance or replacement therapy. Monitor serum potassium levels frequently, especially in patients with renal impairment or those on digoxin. Rapid infusion can cause hyperkalemia and cardiac arrest; maximum infusion rate is 10 mEq/hour via peripheral line. Do not administer undiluted. Use with caution in patients with heart failure or hypertension due to sodium content. |
| Patient Advice | This medication is given intravenously to restore potassium and fluid balance. · Tell your healthcare provider if you have kidney problems, heart disease, or are on blood pressure medications. · Symptoms of high potassium include muscle weakness, numbness, tingling, or irregular heartbeat. · Do not consume potassium supplements or salt substitutes without consulting your doctor. |
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