POTASSIUM CHLORIDE 15MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions for maintaining intracellular tonicity, cellular metabolism, nerve impulse transmission, and muscle contraction. Dextrose 5% provides a source of calories and water for hydration. Sodium chloride 0.225% provides sodium and chloride ions to maintain electrolyte balance and osmotic pressure.
| Metabolism | Potassium is primarily excreted unchanged by the kidneys. Dextrose undergoes glycolysis and oxidative metabolism. Sodium and chloride are excreted primarily by the kidneys. |
| Excretion | Renal excretion: potassium is primarily eliminated by the kidneys; approximately 90% of potassium intake is excreted renally, with the remainder via feces (10%) and negligible biliary elimination. |
| Half-life | Potassium has no defined terminal elimination half-life as it is an electrolyte regulated by homeostasis; redistribution half-life is approximately 4–6 hours. In renal impairment, elimination is prolonged. |
| Protein binding | Potassium is minimally protein bound (<2%) and does not bind significantly to serum proteins such as albumin. |
| Volume of Distribution | Volume of distribution: approximately 0.5–0.6 L/kg. This represents total body water distribution; clinical meaning: potassium distributes predominantly intracellularly (98% of total body potassium), with extracellular Vd reflecting plasma and interstitial fluid. |
| Bioavailability | Intravenous: 100% bioavailability. Not administered orally in this formulation (intravenous only). |
| Onset of Action | Intravenous infusion: immediate onset of action upon administration; effects on serum potassium concentration are observed within minutes, with maximal effect after 2–4 hours depending on infusion rate and distribution. |
| Duration of Action | Intravenous infusion: duration of action is dependent on ongoing requirements; serum potassium levels decline after infusion cessation due to redistribution and renal excretion. Duration of effect on hypokalemia correction is typically 4–6 hours post-infusion, but may be longer with continued losses. |
| Molecular Weight | 74.55 |
Intravenous infusion at a rate not exceeding 10 mEq/hour; typical dose 10-20 mEq over 1-2 hours, may repeat as needed. Maximum 40 mEq per dose, 200 mEq per day.
| Dosage form | INJECTABLE |
| Renal impairment | GFR <30 mL/min: Use with caution, reduce dose by 50% and monitor serum potassium frequently. GFR 30-50 mL/min: Monitor potassium and ECG, reduce rate to ≤5 mEq/hour. GFR >50 mL/min: No adjustment necessary. |
| Liver impairment | No specific adjustment for Child-Pugh class; use cautiously in severe hepatic impairment due to risk of hyperkalemia. |
| Pediatric use | 0.5-1 mEq/kg/dose intravenously over 1-2 hours, maximum rate 0.5 mEq/kg/hour; repeat as needed. Maximum 3 mEq/kg/day or 40 mEq/day. |
| Geriatric use | Initiate at lower end of dosing range, maximum infusion rate 5 mEq/hour; monitor renal function and potassium levels closely. |
| 1st trimester | Potassium chloride is essential for normal cellular function. In pregnancy, potassium requirements may increase. Use as needed for correction of hypokalemia. No evidence of teratogenicity at therapeutic doses. Caution in hyperkalemia or conditions predisposing to hyperkalemia. |
| 2nd trimester | Same as first trimester. Monitor serum potassium closely. Avoid in toxemia or preeclampsia due to potential for volume overload and hyperkalemia. |
| 3rd trimester | Same as above. Avoid in severe preeclampsia/eclampsia due to risk of exacerbating edema and hypertension. 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 diffusion. Fetal serum potassium is controlled within narrow limits; maternal supplementation does not significantly affect fetal levels except in extreme maternal hyperkalemia. |
| Breastfeeding | Potassium chloride is normally present in breast milk. Supplemental potassium is unlikely to affect lactating infants at recommended maternal doses. Monitor infant for signs of hyperkalemia if mother has renal impairment or receives high doses. |
| Lactation Rating | L1 (Compatible) |
| Teratogenic Risk | Potassium chloride supplementation is essential for maternal homeostasis; potassium itself is not teratogenic. However, dextrose and sodium chloride solutions are generally considered safe in pregnancy when used as directed. No specific teratogenic risk has been associated with this combination. First trimester: No increased risk of major congenital anomalies. Second/third trimesters: No fetal harm reported with appropriate maternal potassium repletion. |
| Fetal Monitoring | Monitor serum potassium levels frequently to avoid hypo- or hyperkalemia. Assess renal function (BUN, creatinine) and urine output. Monitor maternal vital signs, ECG for signs of hyperkalemia (peaked T waves, widened QRS) or hypokalemia (U waves, ST changes). Assess fetal heart rate and uterine activity if administered during labor. Monitor for fluid overload (especially with dextrose-containing solution) and signs of hyperglycemia. |
| Fertility Effects | No adverse effects on fertility reported. Adequate potassium balance is essential for normal cellular function; potassium supplementation in deficiency may improve overall reproductive health, but no direct impact on fertility is known. |
■ FDA Black Box Warning
Concentrated potassium chloride solutions are for intravenous use only and must be diluted and administered with caution. Rapid infusion may cause fatal hyperkalemia and cardiac arrest. Do not administer undiluted; use only after dilution in a suitable parenteral solution.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguria or anuriaSevere hemolytic reactionsAddison's diseaseAdynamic ileusAcute dehydrationHeat crampsConcomitant use with potassium-sparing diuretics (except in specific circumstances with careful monitoring)
| Precautions | Monitor serum potassium, glucose, and electrolytes regularly, Use with caution in patients with cardiac disease, renal insufficiency, or conditions predisposing to hyperkalemia, Do not administer rapidly to avoid hyperkalemia and cardiac toxicity, Check for incompatibilities when adding additives, Use with caution in patients with diabetes mellitus due to dextrose content |
| Food/Dietary | Avoid excessive intake of potassium-rich foods (e.g., bananas, oranges, potatoes, spinach, tomatoes) and potassium-containing salt substitutes, as this may increase risk of hyperkalemia. |
| Clinical Pearls | This combination is used for maintenance fluid therapy with potassium replenishment. Monitor serum potassium closely, especially in renal impairment. Do not administer undiluted; IV infusion rate should not exceed 10 mEq/h. Use with caution in patients on potassium-sparing diuretics or ACE inhibitors. Check for incompatibility with other additives. |
| Patient Advice | This medication is given through a vein to replace fluids and potassium. · Report any burning, pain, or redness at the IV site. · Avoid potassium-rich foods and salt substitutes without consulting your doctor. · Do not stop or adjust the infusion rate yourself. · Inform your doctor if you have kidney problems or are taking certain blood pressure medicines. |
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