POTASSIUM CHLORIDE 30MEQ 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 is the major intracellular cation; it is necessary for the conduction of nerve impulses, maintenance of normal cardiac rhythm, and contraction of skeletal and smooth muscle. Dextrose provides calories and is a source of glucose for cellular metabolism. Sodium chloride provides sodium and chloride ions, maintaining 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 and are excreted by the kidneys. |
| Excretion | Renal: >90% as potassium ions; fecal: <10%; minimal biliary elimination. |
| Half-life | Not applicable for potassium; distribution half-life ~0.5-1 h; elimination depends on renal function; in normal renal function, plasma potassium decline follows biphasic pattern with terminal half-life ~2-4 h. |
| Protein binding | None (potassium is not bound to plasma proteins). |
| Volume of Distribution | 0.5-0.7 L/kg; reflects distribution primarily into extracellular fluid (ECF) with slow entry into intracellular space. |
| Bioavailability | Intravenous: 100% (by definition). Oral: 80-90% (not applicable for this IV formulation). |
| Onset of Action | Intravenous: immediate (within minutes) for ECG effects; clinical effect on serum potassium within 30-60 min. |
| Duration of Action | Intravenous: 4-6 h for serum potassium elevation; duration of ECG effect may persist longer depending on total body deficit. |
| Molecular Weight | 74.55 |
Intravenous infusion: 10-20 mEq per hour, not exceeding 40 mEq in 4 hours; maximum 150 mEq per day; dose based on potassium deficit and serum potassium level.
| Dosage form | INJECTABLE |
| Renal impairment | GFR >50 mL/min: no adjustment. GFR 10-50 mL/min: reduce dose by 50% and monitor serum potassium closely. GFR <10 mL/min: use with extreme caution; generally avoid or use only if hypokalemia present with close monitoring. |
| Liver impairment | No specific adjustment required; however, potassium excretion may be impaired in severe hepatic disease (e.g., ascites, cirrhosis) due to secondary hyperaldosteronism; monitor serum potassium closely and adjust dose accordingly. |
| Pediatric use | Intravenous: 0.3-0.5 mEq/kg/hour for maintenance; severe hypokalemia: 0.5-0.7 mEq/kg/hour, not to exceed 20 mEq/hour. Dilute to concentration ≤0.1 mEq/mL (100 mEq/L) for peripheral administration. |
| Geriatric use | Start at low end of dosing range (e.g., 10 mEq over 1-2 hours) due to age-related decline in renal function; maximum infusion rate 20 mEq/hour. Monitor serum potassium and renal function frequently. |
| 1st trimester | Potassium chloride is commonly used to treat or prevent hypokalemia. There are no adequate and well-controlled studies in pregnant women; however, potassium is a normal constituent of body fluids and crosses the placenta. Doses required to correct maternal hypokalemia are generally considered safe. Excessive doses may cause maternal hyperkalemia and adverse fetal effects. |
| 2nd trimester | Same as first trimester. Use with caution to avoid maternal hyperkalemia, which can affect fetal cardiac function. |
| 3rd trimester | Same as second trimester. Monitor maternal serum potassium closely during labor and delivery, as fluctuations can occur. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium freely crosses the placenta via active transport and diffusion. Fetal serum potassium levels are generally maintained within normal range independent of maternal levels, but severe maternal hyperkalemia can lead to fetal hyperkalemia. |
| Breastfeeding | Potassium is normally present in breast milk. Supplemental potassium administered to the mother is unlikely to significantly alter milk concentrations. However, caution is advised with high doses or intravenous administration, as maternal hyperkalemia could theoretically affect the infant. Use only if clearly needed and monitor maternal potassium levels. |
| Lactation Rating | L1 (Compatible) |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride are not known to be teratogenic. No increased risk of fetal malformations has been reported with use during any trimester. |
| Fetal Monitoring | Monitor serum potassium, glucose, and sodium levels; renal function; and fluid balance. Fetal monitoring not routinely required unless maternal electrolyte disturbances occur. |
| Fertility Effects | No known effects on fertility. Standard intravenous solutions are not expected to impair reproductive function. |
■ FDA Black Box Warning
Concentrated potassium solutions should be diluted before administration; rapid infusion may cause hyperkalemia and cardiac arrest. Potassium chloride must be administered with extreme caution, especially in patients with renal impairment, and should be infused via a central line if concentration exceeds 40 mEq/L.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguria, anuria, or azotemiaAddison's diseaseAcute dehydrationHeat crampsConcurrent use of potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride) or ACE inhibitors/ARBs unless carefully monitored
| Precautions | Hyperkalemia risk may be increased with renal impairment, adrenal insufficiency, or concomitant use of potassium-sparing diuretics, ACE inhibitors, or ARBs, Monitor serum potassium levels and ECG during administration, Avoid extravasation; may cause tissue necrosis, Use with caution in patients with heart failure, severe renal failure, or conditions with fluid overload |
| Food/Dietary | Avoid high-potassium foods (e.g., bananas, oranges, potatoes, tomatoes, spinach, avocados) and salt substitutes unless directed by a physician; limit intake of processed foods high in sodium. |
| Clinical Pearls | Administer via central line only if concentration > 60 mEq/L; maximum infusion rate typically 10 mEq/hr for non-emergency; monitor ECG and serum potassium during infusion; contraindicated in hyperkalemia; incompatible with amphotericin B and some cephalosporins; check renal function before use. |
| Patient Advice | This medication is used to treat or prevent low potassium levels. · You may experience burning or pain at the IV site; report this to your nurse. · Avoid salt substitutes containing potassium unless approved by your doctor. · Do not stop this medication abruptly without consulting your healthcare provider. · Tell your doctor if you have kidney problems or are taking potassium-sparing diuretics. |
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