POTASSIUM CHLORIDE 20MEQ 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 tonicity, transmembrane potential, and nerve impulse transmission. Dextrose 5% provides a source of calories and may improve serum osmolality. Sodium chloride 0.9% supplies sodium and chloride ions to maintain extracellular fluid volume and electrolyte balance.
| Metabolism | Potassium is primarily excreted unchanged by the kidneys; no significant hepatic metabolism. Dextrose is metabolized via glycolysis. Sodium and chloride are primarily renally excreted. |
| Excretion | Renal (approximately 90% as potassium ion); minimal biliary/fecal elimination (<5% collectively). |
| Half-life | Not applicable as potassium is an endogenous electrolyte; distribution and elimination follow first-order kinetics with a rapid redistribution phase (t1/2 α ~15 min) and a slower terminal phase (t1/2 β ~6-8 h) reflecting equilibration with total body stores. |
| Protein binding | Minimal (approximately 0-5%); not bound to specific serum proteins, present as free ion. |
| Volume of Distribution | Approximately 0.5–0.7 L/kg (total body water distribution); reflects equilibration with intracellular (98%) and extracellular (2%) compartments. |
| Bioavailability | Intravenous: 100% (complete bioavailability); oral (not applicable for this product): ~90% absorbed with first-pass effect. |
| Onset of Action | Intravenous infusion: immediate upon reaching circulation; oral (not applicable for this formulation but for comparison: onset ~30-60 min). |
| Duration of Action | Intravenous: effect persists as long as infusion maintains serum levels; after discontinuation, serum potassium returns to baseline over hours (depending on total body deficit and renal function). |
| Molecular Weight | 74.55 Da (potassium chloride); dextrose: 180.16 Da |
Intravenous infusion: 10-20 mEq/hour, not to exceed 40 mEq/hour or 200 mEq/day. Maximum concentration: 80 mEq/L via peripheral line, 200 mEq/L via central line. Rate dependent on serum potassium and clinical condition.
| Dosage form | INJECTABLE |
| Renal impairment | GFR >50 mL/min: no adjustment. GFR 10-50 mL/min: reduce dose by 25-50% or extend interval. GFR <10 mL/min: avoid use or use with extreme caution; reduce dose by 50-75% and monitor serum potassium closely. |
| Liver impairment | Child-Pugh A: no adjustment. Child-Pugh B: monitor potassium levels closely; no specific dose reduction required unless renal impairment present. Child-Pugh C: use with caution due to risk of hyperkalemia; individualize dosing based on serum potassium and renal function. |
| Pediatric use | Intravenous infusion: 0.5-1 mEq/kg/day for maintenance; for replacement, 0.3-0.5 mEq/kg per hour with maximum rate 1 mEq/kg/hour. Concentration not to exceed 40 mEq/L peripherally. Dose based on serum potassium and clinical status. |
| Geriatric use | Initiate at lower end of dosing range due to age-related decline in renal function. Maximum infusion rate: 10 mEq/hour. Monitor renal function and serum potassium frequently. Avoid doses exceeding 100 mEq per day unless severe hypokalemia. |
| 1st trimester | Potassium chloride is considered safe in pregnancy when used as supplementation for documented hypokalemia. Dextrose and sodium chloride are standard IV fluids. No increased risk of major malformations has been reported with potassium administration. |
| 2nd trimester | Use only if clearly needed for electrolyte imbalance. Monitor serum potassium to avoid hyperkalemia. Dextrose may affect maternal glucose; use with caution in gestational diabetes. |
| 3rd trimester | IV potassium can be used for hypokalemia. Monitor maternal potassium and fetal heart rate. Dextrose may cause fetal hyperinsulinemia if maternal hyperglycemia occurs. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium crosses the placenta freely via active transport and diffusion; fetal serum potassium is similar to maternal. Dextrose crosses via facilitated diffusion. Sodium and chloride cross by active transport. |
| Breastfeeding | Potassium chloride is normal constituent of breast milk. IV administration does not affect milk composition significantly. Dextrose and sodium chloride are also safe. However, avoid excessive potassium supplementation as it may affect maternal serum levels. |
| Lactation Rating | L1 (Compatible) |
| Teratogenic Risk | Potassium chloride is not associated with teratogenic risk in humans. There is no evidence of fetal harm from potassium administration at recommended doses. However, maternal hyperkalemia may cause fetal arrhythmia or adverse effects. Dextrose and sodium chloride are considered safe when used appropriately. |
| Fetal Monitoring | Monitor serum potassium, glucose, and electrolytes regularly. Observe for signs of hyperkalemia (ECG changes, muscle weakness, arrhythmias) or fluid overload. Fetal heart rate monitoring may be indicated if maternal electrolyte disturbances occur. |
| Fertility Effects | No known adverse effects on fertility. Potassium chloride, dextrose, and sodium chloride do not impair reproductive function at standard therapeutic doses. |
■ FDA Black Box Warning
Concentrated potassium chloride solutions (≥20 mEq per 100 mL) must be diluted before administration to avoid fatal hyperkalemia. Administration must be via an infusion pump for rate control.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguria or anuriaConcomitant use with potassium-sparing diuretics (unless closely monitored)Addison's disease (untreated)Acute dehydrationHeat cramps
| Precautions | Risk of hyperkalemia, especially in patients with renal impairment, adrenal insufficiency, or potassium-sparing diuretics, Monitor serum potassium and ECG during administration, Extravasation may cause tissue necrosis, Use with caution in patients with heart failure, edema, or conditions that cause sodium retention |
| Food/Dietary | Avoid potassium-rich foods (bananas, oranges, potatoes, spinach, tomatoes, avocados) and salt substitutes containing potassium chloride to prevent hyperkalemia. Do not consume excessive amounts of high-potassium foods without medical guidance. |
| Clinical Pearls | Administer via slow IV infusion at a maximum rate of 10 mEq/hour; use a central line for concentrations above 40 mEq/L due to risk of phlebitis. Monitor serum potassium and ECG continuously during infusion. Contraindicated in severe renal impairment, hyperkalemia, or Addison's disease. Do not use as a bolus; risk of cardiac arrest. |
| Patient Advice | This medication is given intravenously to correct low potassium levels. · Do not suddenly stop other potassium supplements unless directed by your doctor. · Report symptoms of hyperkalemia: muscle weakness, palpitations, tingling in hands/feet. · Avoid potassium-containing salt substitutes or excessive potassium-rich foods while on this therapy. |
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