POTASSIUM CHLORIDE 20MEQ 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 chloride replaces potassium ions, which are essential for maintaining intracellular tonicity, nerve impulse conduction, muscle contraction, and acid-base balance. Dextrose 5% provides a source of calories and water for hydration. Sodium chloride 0.45% provides sodium and chloride ions to maintain extracellular fluid volume and osmolality.
| Metabolism | Potassium is primarily excreted unchanged by the kidneys. Dextrose is metabolized via glycolysis and the Krebs cycle. Sodium and chloride are eliminated renally. |
| Excretion | Renal: >90% as potassium ions, with a small fraction in feces (<5%). Biliary excretion is negligible. |
| Half-life | Not applicable as potassium is an electrolyte regulated by homeostasis; the terminal half-life for administered potassium in healthy individuals is approximately 2-3 hours, reflecting distribution and renal excretion. |
| Protein binding | Minimal; potassium is not significantly protein-bound (<2%). |
| Volume of Distribution | Approximately 0.5 L/kg, reflecting distribution primarily into extracellular fluid; total body potassium is about 50 mEq/kg, with most intracellular. |
| Bioavailability | Oral: 90-100% (rapidly absorbed from gastrointestinal tract); intravenous: 100%. |
| Onset of Action | Intravenous infusion: onset within minutes as plasma concentration rises; oral administration: onset within 1-2 hours for gastrointestinal absorption. |
| Duration of Action | Intravenous infusion: duration of effect depends on infusion rate and renal function, typically lasting for the duration of infusion plus post-infusion redistribution; oral: effect lasts up to 4-6 hours post-dose, depending on dose and renal handling. |
Intravenous infusion; dose determined by serum potassium level. Typical maintenance: 20 mEq in 1000 mL at 10-20 mEq/hour. Max infusion rate: 10 mEq/hour (peripheral) or 20 mEq/hour (central).
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-50 mL/min: reduce dose by 25-50%. GFR <30 mL/min: avoid use or reduce dose by 50-75% with close monitoring. GFR <15 mL/min: contraindicated unless dialysis is available. |
| Liver impairment | No specific Child-Pugh based guidelines; use with caution in severe hepatic impairment due to risk of acid-base disturbances. |
| Pediatric use | Neonates: 0.5-1 mEq/kg/dose IV; Infants/Children: 0.5-1 mEq/kg/dose IV, max single dose 20 mEq; infusion rate not to exceed 0.5 mEq/kg/hour. |
| Geriatric use | Use lower initial doses; monitor renal function and serum potassium frequently; infusion rates typically 10 mEq/hour maximum. |
| 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 is a normal constituent of breast milk. IV potassium chloride supplementation does not significantly affect milk levels. M/P ratio not available. Considered compatible with breastfeeding. |
| Teratogenic Risk | Potassium chloride is an essential electrolyte and not teratogenic at physiological concentrations. No evidence of fetal harm from IV potassium administration in pregnancy. However, maternal hyperkalemia may cause fetal arrhythmias or death. Third trimester: risk of uterine hypertonicity with high doses. |
■ FDA Black Box Warning
No FDA black box warning for this specific combination product. However, potassium chloride concentrated solutions have a black box warning for fatal cardiac arrhythmias if administered improperly.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Severe renal impairment with oliguria or anuria","Concurrent use of potassium-sparing diuretics or ACE inhibitors that may cause hyperkalemia","Uncontrolled Addison's disease","Edema with sodium retention"]
| Precautions | ["Risk of hyperkalemia and cardiac arrhythmias, especially in patients with renal impairment","Rapid infusion may cause hyperglycemia, hyperosmolality, and fluid overload","Use with caution in patients with heart failure, pulmonary edema, or renal insufficiency","Monitor serum potassium, glucose, and electrolytes during therapy","Do not administer concentrated potassium solutions undiluted"] |
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| Fetal Monitoring | Monitor serum potassium, glucose, electrolytes, and fluid balance. Fetal heart rate monitoring if maternal hyperkalemia or rapid infusion. Assess for signs of hyperkalemia (ECG changes, muscle weakness). |
| Fertility Effects | No known adverse effects on fertility. Normal potassium balance is essential for reproductive function. |