POTASSIUM CHLORIDE 15MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium is the major intracellular cation; it is essential for maintenance of intracellular tonicity, transmission of nerve impulses, contraction of cardiac, skeletal, and smooth muscle, and maintenance of normal renal function. Dextrose is a monosaccharide that provides calories and may induce osmotic diuresis. Sodium chloride is an electrolyte that maintains fluid and electrolyte balance.
| Metabolism | Potassium is not metabolized; it is excreted primarily by the kidneys. Dextrose is metabolized via glycolysis and the Krebs cycle. Sodium and chloride are not metabolized but are excreted renally. |
| Excretion | Renal excretion: >90% of potassium is excreted by the kidneys, primarily via distal tubular secretion. Fecal elimination accounts for <10%, mainly through gastrointestinal secretion. Biliary excretion is negligible. |
| Half-life | The terminal elimination half-life of potassium is not classically defined due to tight homeostatic regulation; however, the biological half-life for exchangeable potassium in the body is approximately 30 days (range 20-40 days) in adults, reflecting slow turnover of intracellular stores. Clinical context: acute shifts from IV infusion are rapidly distributed, with redistribution half-life of ~1-2 hours, but total body elimination depends on renal function. |
| Protein binding | Potassium is not significantly bound to plasma proteins; protein binding is negligible (<1%). |
| Volume of Distribution | The apparent volume of distribution (Vd) for potassium is approximately 0.5-0.7 L/kg, reflecting distribution primarily in the extracellular fluid (ECF) and exchange with intracellular fluid (ICF). Clinical meaning: The large Vd (total body water) indicates extensive tissue distribution; only ~2% of total body potassium is in ECF. |
| Bioavailability | Oral: Approximately 90-100% of potassium chloride is absorbed from the gastrointestinal tract. Intravenous: 100% bioavailability (direct administration into systemic circulation). Note: For potassium chloride in a parenteral solution, only IV administration is relevant; bioavailability is 100%. |
| Onset of Action | Intravenous: Onset of action for correction of hypokalemia is within minutes to 1 hour, depending on infusion rate and severity of deficit. Oral: Onset is variable, typically 30-60 minutes after oral administration, but clinical effect may be delayed until redistribution into cells occurs. |
| Duration of Action | Intravenous: Duration of action post-infusion is approximately 2-4 hours for acute effects on serum potassium, but lasting correction requires continued administration or oral therapy. Oral: Duration of action for sustained-release formulations extends up to 8-12 hours; immediate-release forms have shorter duration (~4-6 hours). Clinical note: Continuous maintenance therapy is often needed to replenish total body stores. |
Intravenous infusion at a rate not exceeding 10 mEq/hour and concentration not exceeding 40 mEq/L. Typical adult dose is 10-20 mEq administered over 1-2 hours, repeated as needed based on serum potassium levels. Maximum daily dose is usually 200 mEq.
| Dosage form | INJECTABLE |
| Renal impairment | GFR >50 mL/min: no adjustment. GFR 10-50 mL/min: reduce dose by 25-50% and monitor serum potassium closely. GFR <10 mL/min: avoid use or use with extreme caution; maximum dose 20 mEq per day with continuous monitoring. |
| Liver impairment | Child-Pugh Class A: no adjustment. Child-Pugh Class B: reduce dose by 25% and monitor serum potassium. Child-Pugh Class C: avoid use due to risk of hyperkalemia and altered potassium homeostasis. |
| Pediatric use | Intravenous infusion: 0.5-1 mEq/kg/dose, not to exceed 40 mEq/dose. Administer at a rate not exceeding 0.5-1 mEq/kg/hour. Maximum concentration 40 mEq/L. Adjust based on serum potassium levels. |
| Geriatric use | Start at low end of dosing range due to decreased renal function. Maximum infusion rate 5 mEq/hour. Monitor renal function and serum potassium frequently. Avoid in patients with significant renal impairment. |
| 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 normal constituents of breast milk. No adverse effects on nursing infant expected at maternal therapeutic doses. M/P ratio for potassium is approximately 1.0. Use caution with high maternal doses. |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride are physiological electrolytes and nutrients. No teratogenic effects have been reported at therapeutic doses. Inadvertent hyperkalemia, hyperglycemia, or hypernatremia may cause fetal distress. Risk is minimal when used as indicated. |
■ FDA Black Box Warning
Potassium chloride concentrate must be diluted and used only in patients with adequate urine flow. Rapid infusion may cause hyperkalemia and cardiac arrest. Do not administer undiluted.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Severe renal impairment with oliguria or anuria","Addison's disease","Acute dehydration","Heat cramps","Concurrent use of potassium-sparing diuretics (e.g., spironolactone, eplerenone)","Hypersensitivity to any component"]
| Precautions | ["Risk of hyperkalemia: monitor serum potassium and renal function, especially in patients with renal impairment, heart disease, or on potassium-sparing diuretics","Extravasation may cause tissue necrosis","Use with caution in patients with heart failure, severe renal impairment, or adrenal insufficiency","Monitor for signs of fluid overload (especially in patients with compromised cardiovascular function)"] |
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| Fetal Monitoring | Monitor serum electrolytes (potassium, sodium, glucose), renal function, and acid-base status. In pregnancy, monitor maternal blood pressure, fluid balance, and fetal heart rate if administered IV. Assess for signs of hyperkalemia (ECG changes), hyperglycemia, or fluid overload. |
| Fertility Effects | No known effects on fertility at therapeutic doses. Electrolyte disturbances from overdose may impair reproductive function, but standard use is not associated with altered fertility. |