POTASSIUM CHLORIDE 40MEQ 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 maintains cellular membrane potential, acid-base balance, and fluid balance. Dextrose provides caloric supplementation; sodium chloride provides sodium and chloride ions for electrolyte balance.
| Metabolism | Potassium is primarily excreted by the kidneys. Dextrose is metabolized via glycolysis and oxidative phosphorylation. Sodium and chloride are excreted renally. |
| Excretion | Primarily renal (90% excreted unchanged in urine); minor fecal (10%) |
| Half-life | Not applicable; potassium disposition follows first-order kinetics with rapid redistribution; serum half-life is normally 1-1.5 hours, but may be prolonged in renal impairment |
| Protein binding | Minimal; less than 5% bound; no specific binding protein |
| Volume of Distribution | 0.4-0.6 L/kg; reflects distribution primarily in extracellular fluid; higher Vd indicates larger body stores |
| Bioavailability | Intravenous: 100% bioavailable; oral formulations (not applicable here) have high bioavailability |
| Onset of Action | Intravenous: immediate (minutes); the formulation (D5W/0.9% NaCl) does not alter onset |
| Duration of Action | Intravenous effect lasts for duration of infusion plus post-infusion redistribution; typically 1-2 hours after infusion ends; clinical effect on serum potassium persists for several hours depending on dose and patient status |
| Molecular Weight | 74.55 |
40 mEq potassium chloride intravenously, administered at a rate not exceeding 10 mEq/hour and a concentration no greater than 40 mEq/L. For severe hypokalemia, may be infused at up to 20 mEq/hour with continuous ECG monitoring.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR 50-90 mL/min: no adjustment. For GFR 10-49 mL/min: reduce dose by 50% and monitor serum potassium closely. For GFR <10 mL/min: contraindicated unless severe deficiency, with maximum rate 10 mEq/hour and frequent monitoring. |
| Liver impairment | No specific adjustment for Child-Pugh class A or B. For Child-Pugh class C: caution due to potential for hyperkalemia; monitor serum potassium and ECG; consider dose reduction if concomitant renal impairment. |
| Pediatric use | Neonates and infants: 0.5-1 mEq/kg/dose IV, not to exceed 40 mEq/day, infused at 0.3-0.5 mEq/kg/hour. Children: 1-2 mEq/kg/dose IV, maximum 40 mEq/dose, infused at 0.3-0.5 mEq/kg/hour. Continuous infusion: 0.2-0.4 mEq/kg/hour. Avoid concentrations >40 mEq/L in peripheral IV. |
| Geriatric use | Initiate at lower end of adult dosing (e.g., 20-40 mEq per day) due to decreased renal function and increased risk of hyperkalemia. Infusion rate not to exceed 5-10 mEq/hour. Monitor serum potassium and renal function weekly. |
| 1st trimester | Potassium chloride is generally considered safe for use during all trimesters when clinically indicated, as it is an essential electrolyte. However, excessive or rapid administration may cause maternal hyperkalemia with potential fetal effects. Use with caution. |
| 2nd trimester | Same as t1. Potassium is a critical electrolyte; supplement only for documented deficiency or specific clinical need. |
| 3rd trimester | Same as t1. In labor, consider potential for uterine tone changes; use only when clearly indicated. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium crosses the placenta by active transport and diffusion; maternal-fetal gradient maintained. Fetal serum potassium is slightly higher than maternal. Significant transfer occurs, but is physiologic in normal doses. |
| Breastfeeding | Potassium is a normal constituent of breast milk; supplementation is generally compatible with breastfeeding. No adverse effects in infants reported when given to mother in usual doses. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Pregnancy category C. First trimester: no known teratogenic effects from potassium chloride; however, dextrose and sodium chloride are considered safe. Second and third trimesters: no known fetal risks from potassium, dextrose, or sodium chloride at therapeutic doses. Risk of electrolyte imbalance in mother may affect fetus. |
| Fetal Monitoring | Monitor serum potassium, glucose, and sodium levels; renal function; ECG for cardiac effects; maternal vital signs; fetal heart rate monitoring if maternal electrolyte disturbances occur. |
| Fertility Effects | No known effects on fertility from potassium chloride, dextrose, or sodium chloride at therapeutic doses. |
■ FDA Black Box Warning
No FDA black box warning for this specific combination product. However, potassium chloride injection carries a black box warning for the risk of fatal hyperkalemia if administered too rapidly or in high concentrations.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguria or anuriaConcurrent use with potassium-sparing diuretics (except with careful monitoring)Known hypersensitivity to potassium chloride
| Precautions | Risk of hyperkalemia; monitor serum potassium levels frequently, Use with caution in patients with renal impairment, cardiac disease, or conditions predisposing to hyperkalemia, Do not administer concentrated potassium solutions undiluted, Monitor for fluid overload, especially in patients with heart failure or renal insufficiency |
| Food/Dietary | Avoid high-potassium foods (e.g., bananas, oranges, potatoes, spinach, avocados, dried fruits) and potassium-containing salt substitutes during treatment to prevent hyperkalemia. |
| Clinical Pearls | Use central line for infusion of potassium >10 mEq/h; monitor ECG during rapid correction; never give IV push; check renal function before administration; rate of infusion should not exceed 10-20 mEq/h in peripheral line to avoid phlebitis; avoid in patients with hyperkalemia, severe renal impairment, or conditions that cause potassium retention. |
| Patient Advice | This medication is given intravenously to correct low potassium levels. · Report any pain, redness, or swelling at the IV site immediately. · Avoid potassium-rich foods and salt substitutes unless approved by your doctor. · Do not stop or adjust the infusion rate on your own. · Inform your healthcare provider if you have kidney problems or are taking ACE inhibitors or potassium-sparing diuretics. |
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