POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride (KCl) provides potassium ions, essential for maintenance of intracellular tonicity, nerve impulse transmission, muscle contraction, and enzymatic reactions. Dextrose 5% provides glucose for energy, and sodium chloride 0.45% provides sodium and chloride ions for electrolyte balance and volume expansion.
| Metabolism | Potassium is primarily eliminated by the kidneys; dextrose is metabolized to carbon dioxide and water via glycolysis and the citric acid cycle; sodium and chloride are excreted mainly by the kidneys and are not metabolized. |
| Excretion | Renal: >90% excreted unchanged by kidneys. Fecal: <10% via secretion into feces. |
| Half-life | Terminal elimination half-life is approximately 3-5 minutes for rapid redistribution phase; effective half-life for total body potassium is 30-40 hours due to large intracellular pool. Clinical context: immediately after IV infusion, plasma potassium declines rapidly due to cellular uptake, but total elimination depends on renal function. |
| Protein binding | Not significantly protein-bound (<10%); free ion in plasma. |
| Volume of Distribution | Approximately 0.5 L/kg (range 0.4-0.6 L/kg) reflecting distribution primarily into extracellular fluid; apparent Vd larger (5-10 L/kg) for total body potassium due to intracellular compartment. |
| Bioavailability | Oral: 100% bioavailability for potassium as it is completely absorbed from the gastrointestinal tract, though immediate release formulations have high bioavailability; IV: 100%. |
| Onset of Action | Intravenous: immediate (within seconds to minutes) for correction of hypokalemia; oral: 30-60 minutes for gastrointestinal absorption. |
| Duration of Action | Intravenous: 1-2 hours for direct plasma effect, but prolonged effect on total body potassium depends on renal excretion and cellular uptake; oral: sustained effect over 4-6 hours with KCl formulation. |
40 mEq potassium chloride intravenously at a rate not exceeding 10 mEq/hour; typically infused over 4-6 hours. Maximum 24-hour dose: 200 mEq.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 10-50 mL/min: reduce dose by 25-50%. GFR <10 mL/min: avoid use or administer with extreme caution, not to exceed 20 mEq/24h. |
| Liver impairment | No specific adjustment required; monitor serum potassium closely due to risk of hyperkalemia in severe hepatic impairment (Child-Pugh class C). |
| Pediatric use | 0.5-1 mEq/kg/dose IV, max single dose 40 mEq; infuse at 0.3-0.5 mEq/kg/hour. Maximum daily dose: 2-3 mEq/kg/day. |
| Geriatric use | Start at low end of dosing range; reduce infusion rate (max 5 mEq/hour) and monitor renal function and serum potassium frequently due to age-related decline in GFR. |
| 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, dextrose, and sodium chloride are normal constituents of breast milk. Potassium supplementation does not alter milk composition significantly. M/P ratio not applicable; compatible with breastfeeding. |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride are not teratogenic. Dextrose and sodium chloride are physiological components. Potassium supplementation is not associated with increased fetal risk. No trimester-specific risks identified. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Severe renal failure with oliguria or anuria","Addison's disease","Untreated diabetic ketoacidosis","Severe dehydration or hypovolemic shock","Concurrent therapy with potassium-sparing diuretics or potassium supplements (except in monitored settings)"]
| Precautions | ["Monitor serum potassium levels regularly; avoid rapid or high-dose administration to prevent hyperkalemia","Use with caution in patients with renal impairment, cardiac disease, or conditions predisposing to hyperkalemia","Do not administer unless solution is clear and container is undamaged","Dextrose-containing solutions may cause hyperglycemia; monitor blood glucose in diabetic patients"] |
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| Fetal Monitoring | Monitor serum potassium, glucose, and sodium levels. Assess maternal vital signs, fluid balance, and renal function. Fetal monitoring indicated if maternal electrolyte disturbances occur. |
| Fertility Effects | No known effects on fertility from potassium, dextrose, or sodium chloride administration at therapeutic doses. |