POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions for electrolyte balance; dextrose provides caloric support; sodium chloride provides sodium and chloride ions for fluid and electrolyte balance.
| Metabolism | Potassium chloride is not metabolized; dextrose is metabolized via glycolysis and oxidative phosphorylation; sodium chloride is renally excreted without metabolism. |
| Excretion | Renal: >90% as potassium ion. Biliary/fecal: <10%. |
| Half-life | Not applicable; potassium is an electrolyte, not a drug with a half-life. Serum potassium half-life depends on distribution and elimination, but is not routinely measured. Potassium is rapidly distributed and excreted with a plasma disappearance half-life of approximately 1-1.5 hours after IV infusion in healthy individuals. |
| Protein binding | Minimal; not bound to plasma proteins. |
| Volume of Distribution | Total body potassium Vd ~0.4-0.6 L/kg (reflects distribution mainly into intracellular fluid, where 98% of body potassium resides). |
| Bioavailability | IV: 100%. Oral: 80-90% (not relevant for this IV formulation). |
| Onset of Action | IV: Immediate (seconds to minutes). |
| Duration of Action | IV: Duration of effect depends on infusion rate and ongoing losses; typically 1-2 hours after infusion stops. Continuous infusion maintains effect. |
| Molecular Weight | 74.55 |
40-100 mEq potassium chloride intravenously per day, infused at a rate not exceeding 10-20 mEq/hour, with continuous ECG monitoring. Dose and rate depend on serum potassium levels and clinical status.
| Dosage form | INJECTABLE |
| Renal impairment | GFR >50 mL/min: no adjustment. GFR 30-50 mL/min: reduce dose by 50%, monitor potassium closely. GFR <30 mL/min: avoid unless severe deficiency with close monitoring; use with extreme caution due to risk of hyperkalemia. |
| Liver impairment | No specific adjustments for Child-Pugh classification; monitor potassium levels and renal function as hepatic impairment may affect acid-base balance and potassium handling. |
| Pediatric use | 0.5-1 mEq/kg/dose intravenously, maximum rate 0.3-0.5 mEq/kg/hour, not to exceed 1 mEq/kg/hour. Total daily dose: 2-4 mEq/kg/day, with monitoring of serum potassium and ECG. |
| Geriatric use | Use lower initial doses (e.g., 20-40 mEq/day) and slower infusion rates (≤10 mEq/hour) due to age-related decline in renal function and higher risk of hyperkalemia. Monitor renal function and serum potassium frequently. |
| 1st trimester | Potassium chloride is a normal constituent of body fluids; at therapeutic doses, no increased risk of major malformations has been observed. However, hyperkalemia from excessive administration can cause fetal arrhythmias or death. |
| 2nd trimester | Use only if clearly needed; monitor maternal serum potassium to avoid hyperkalemia. Fetal risk is dose-related. |
| 3rd trimester | Continuous ECG monitoring recommended if intravenous administration is required due to risk of maternal and fetal hyperkalemia. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium crosses the placenta via active transport; fetal serum potassium is typically higher than maternal. Excessive maternal potassium leads to increased fetal levels, with risk of fetal hyperkalemia. |
| Breastfeeding | Potassium chloride is a normal component of breast milk; supplementation at recommended doses is compatible with breastfeeding. However, intravenous administration may transiently alter milk potassium content; avoid excessive doses. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Potassium chloride is a normal constituent of body fluids; at physiological doses, no teratogenic risk is expected. For the dextrose component, hyperglycemia during pregnancy may be associated with fetal anomalies, but dextrose 5% is isotonic and provides a moderate glucose load; risk is minimal with controlled maternal glucose. Sodium chloride 0.3% is hypotonic but diluted; no direct teratogenic risk. Overall, no known teratogenic effect from this combination when used appropriately. First trimester: No evidence of increased risk. Second and third trimesters: Potential for electrolyte disturbances if maternal potassium imbalances occur, but usual doses are safe. |
| Fetal Monitoring | Monitor serum potassium levels, blood glucose, and vital signs during infusion. Assess for signs of hyperkalemia (ECG changes, muscle weakness) or hypoglycemia. Fetal heart rate monitoring recommended during administration for obstetric indications; maternal fluid status and urine output should be monitored to avoid fluid overload. |
| Fertility Effects | No known adverse effects on fertility. Potassium, dextrose, and sodium chloride are essential nutrients, and replacement therapy at therapeutic doses does not impair reproductive function. |
■ FDA Black Box Warning
Concentrated potassium chloride injections must be diluted before use to prevent fatal hyperkalemia. Do not administer undiluted or as a bolus injection.
| Common Effects | fluid replacement |
| Serious Effects |
Hyperkalemia (serum potassium > 5.0 mEq/L)Severe renal impairment (oliguria or anuria)Concurrent use of potassium-sparing diuretics (e.g., spironolactone, eplerenone) Addison's disease (untreated)
| Precautions | Monitor serum potassium levels during therapy to avoid hyperkalemia, especially in patients with renal impairment, Risk of fluid overload in patients with cardiac or renal disease, Avoid rapid infusion of solutions containing dextrose in patients with glucose intolerance, Do not use in patients with hyperkalemia or severe renal dysfunction |
| Food/Dietary | Avoid potassium-rich foods (bananas, oranges, spinach, potatoes, avocados, tomatoes) and salt substitutes containing potassium chloride. Limit intake of high-sodium foods as this solution contains sodium chloride. |
| Clinical Pearls | This hypertonic solution (D5 0.3% NaCl) provides potassium supplementation in a hypokalemic patient with concurrent fluid/electrolyte needs. Rate of administration should not exceed 10-20 mEq/hour via peripheral line; central line preferred for higher rates. Monitor ECG and serum potassium levels continuously. Contraindicated in severe renal impairment, hyperkalemia, or Addison's disease. Do not administer undiluted. |
| Patient Advice | This medication contains potassium, which is essential for heart and muscle function. · You will receive this through a vein; report any pain, redness, or swelling at the IV site. · Do not consume potassium-rich foods or supplements without consulting your doctor. · Tell your doctor if you have kidney problems, heart block, or are taking ACE inhibitors, ARBs, or potassium-sparing diuretics. · Seek immediate help if you experience muscle weakness, irregular heartbeat, or tingling in hands/feet. |
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