POTASSIUM CHLORIDE 15MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions essential for maintaining intracellular osmotic pressure, acid-base balance, and nerve impulse transmission. Dextrose 5% provides glucose for cellular metabolism, and sodium chloride 0.9% provides sodium and chloride ions to maintain extracellular fluid volume and osmolality.
| Metabolism | Potassium is not metabolized; it is excreted primarily by the kidneys. Dextrose is metabolized via glycolysis and the citric acid cycle. Sodium and chloride are excreted renally. |
| Excretion | Renal: >90% of potassium intake is excreted by the kidneys, primarily via distal tubular secretion; <10% fecal, minimal biliary. |
| Half-life | Not applicable as potassium is an electrolyte with distribution and elimination dependent on body stores and renal function; in healthy individuals, clearance is rapid with no defined terminal half-life, but in renal impairment, half-life extends. |
| Protein binding | None (0%); potassium is freely ionized in plasma. |
| Volume of Distribution | 0.5 L/kg; distributes primarily in extracellular fluid (ECF), with intracellular shift occurring slowly. |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: Immediate (within minutes) as potassium equilibrates with extracellular fluid. |
| Duration of Action | Intravenous: Duration is dose- and rate-dependent; continuous infusion provides sustained effect; discontinuation leads to rapid decline in serum levels within minutes. |
| Molecular Weight | 74.55 |
Intravenous infusion, 15 mEq potassium chloride in 5% dextrose and 0.9% sodium chloride at a rate not exceeding 10 mEq/hour; frequency based on serum potassium levels and clinical need.
| 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 use or use with extreme caution. |
| Liver impairment | Child-Pugh A: no adjustment; Child-Pugh B: monitor potassium closely; Child-Pugh C: avoid use or use with caution. |
| Pediatric use | 0.5-1 mEq/kg/dose intravenously, maximum rate 0.5-1 mEq/kg/hour; maximum daily dose 3 mEq/kg or 40 mEq/m2. |
| Geriatric use | Start at lower end of dosing range due to age-related renal impairment; monitor renal function and serum potassium frequently. |
| 1st trimester | Potassium chloride is a normal constituent of body fluids and is essential for cellular function. Intravenous administration is generally considered safe when used for correction of hypokalemia or maintenance in pregnant women. No increased risk of fetal abnormalities has been reported with appropriate use. |
| 2nd trimester | Same as first trimester. Use only if clearly needed and under careful monitoring to avoid hyperkalemia which could be harmful to both mother and fetus. |
| 3rd trimester | Same as first and second trimesters. Monitor maternal potassium levels closely as hyperkalemia can lead to arrhythmias and uterine contractions. |
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 passive diffusion to maintain fetal-maternal gradient. Fetal potassium levels are usually higher than maternal. Placental transfer is substantial and regulated by fetal needs. |
| Breastfeeding | Potassium is a normal component of breast milk. Intravenous potassium chloride administration to the mother results in minimal changes to milk potassium levels. However, caution is advised with high doses or in renal impairment to avoid maternal hyperkalemia. Generally considered compatible with breastfeeding, but monitor infant for electrolyte disturbances. |
| Lactation Rating | L2: Safer |
| Teratogenic Risk | Potassium chloride is not teratogenic. It is a normal physiological component. No increased risk of fetal malformations. Parenteral administration is unlikely to cause teratogenicity. |
| Fetal Monitoring | Monitor maternal serum potassium, renal function, and ECG for hyperkalemia. Fetal heart rate monitoring is not specifically required but may be indicated if maternal hyperkalemia develops. |
| Fertility Effects | At therapeutic doses, no adverse effects on fertility. High doses may cause hyperkalemia, which could indirectly affect reproductive function, but no direct effect on fertility. |
■ FDA Black Box Warning
Potassium chloride concentrate injection is a life-threatening medication that must be diluted before use. Undiluted injection can cause cardiac arrest.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaAdrenal insufficiency (addisonian crisis)Severe renal impairment with oliguria, anuria, or azotemiaAcute dehydrationHeat crampsPatients receiving potassium-sparing diuretics (e.g., spironolactone, amiloride, eplerenone)Concurrent use of amiloride or triamtereneImpaired renal function (risk of hyperkalemia)
| Precautions | Monitor serum potassium levels and renal function, Cardiac monitoring recommended during administration, Use with caution in patients with heart disease, renal impairment, or metabolic acidosis, Risk of hyperkalemia, especially in renal insufficiency, Dextrose may cause hyperglycemia; use with caution in diabetes |
| Food/Dietary | Avoid high-potassium foods (bananas, oranges, spinach, potatoes, avocados, tomatoes) and potassium-containing salt substitutes to prevent hyperkalemia. |
| Clinical Pearls | Do not administer undiluted; IV infusion rate must not exceed 10 mEq/h unless severe hypokalemia is present with continuous ECG monitoring. Use central line if concentration > 40 mEq/L. Contraindicated in severe renal impairment, hyperkalemia, and conditions with potassium retention. Monitor serum potassium, renal function, and ECG during infusion. |
| Patient Advice | Report any burning or pain at the IV site immediately. · Do not adjust the infusion rate yourself. · Tell your healthcare provider if you have kidney problems or are taking potassium-sparing diuretics or ACE inhibitors. · Avoid potassium-rich foods and salt substitutes unless directed by your doctor. |
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