POTASSIUM CHLORIDE 5MEQ 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 essential for maintenance of intracellular tonicity, transmission of nerve impulses, contraction of cardiac and skeletal muscle, and normal renal function. Dextrose is a source of calories and fluid. Sodium chloride is an electrolyte replenisher.
| Metabolism | Potassium is not metabolized; it is excreted primarily by the kidneys. Dextrose is metabolized via glycolysis and subsequent oxidative pathways. Sodium and chloride are handled by renal regulation. |
| Excretion | Primarily renal (90% or more) as potassium ion via glomerular filtration and tubular secretion; minimal biliary/fecal (<5%). |
| Half-life | Not applicable as potassium is not eliminated by first-order kinetics; clearance depends on renal function (GFR) and tubular handling. In patients with normal renal function, plasma potassium declines rapidly after IV infusion, with a distribution half-life of approximately 1 hour and an elimination half-life of 12-24 hours for excess potassium, but this is clinically not used. The terminal half-life is not defined due to physiological regulation. |
| Protein binding | Negligible; potassium is not significantly bound to plasma proteins (0-10%). |
| Volume of Distribution | Approximately 0.5-0.7 L/kg (total body water); distributes rapidly into extracellular and intracellular compartments, with intracellular concentration (~150 mEq/L) much higher than extracellular (3.5-5 mEq/L). |
| Bioavailability | Oral: ~90% as potassium chloride in solution (well absorbed from GI tract). Intravenous: 100%. |
| Onset of Action | Intravenous: Rapid, within minutes for cardiac effects (e.g., ECG changes) at appropriate infusion rates. Oral: 30-60 minutes for gastrointestinal absorption. |
| Duration of Action | Intravenous: Duration depends on dose and renal function; typically 2-4 hours for serum potassium elevation after rapid infusion, but continuous infusion is used for sustained effect. Oral: Effect lasts 4-6 hours for a single dose, but sustained-release may last longer. |
| Molecular Weight | 74.55 |
Intravenous, 10-20 mEq/hour, not to exceed 40 mEq per dose or 200 mEq per day; rate not to exceed 1 mEq/kg/hour. Typical maintenance: 40-80 mEq/day.
| Dosage form | INJECTABLE |
| Renal impairment | GFR <30 mL/min: avoid use or reduce dose by 50%; monitor potassium levels closely. GFR 30-50 mL/min: reduce dose by 25-50% and monitor. GFR >50 mL/min: no adjustment necessary. |
| Liver impairment | No specific adjustment required based on Child-Pugh score; monitor potassium levels due to potential renal complications in hepatic disease. |
| Pediatric use | Intravenous, 0.5-1 mEq/kg/dose, maximum 1 mEq/kg/hour, not to exceed 30 mEq per dose; maintenance: 2-3 mEq/kg/day. |
| Geriatric use | Start at lower end of dosing range (e.g., 10-20 mEq/day); monitor renal function and serum potassium frequently due to age-related decline in GFR and increased sensitivity. |
| 1st trimester | Potassium chloride is a normal constituent of body fluids. Intravenous administration is considered safe when indicated. No known teratogenic risk. |
| 2nd trimester | Same as first trimester. Monitor serum potassium levels. |
| 3rd trimester | Same as first trimester. Monitor serum potassium and fetal heart rate if high doses. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium crosses placenta readily to maintain fetal-maternal equilibrium. |
| Breastfeeding | Potassium chloride is a normal component of breast milk; administration is considered compatible with breastfeeding. |
| Lactation Rating | Safe |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride at standard replacement doses are not teratogenic. There are no known fetal risks associated with appropriate electrolyte and fluid administration. High doses leading to maternal hyperkalemia may cause fetal arrhythmias. Dextrose infusion may cause fetal hyperglycemia and hyperinsulinemia, especially if maternal glucose is poorly controlled. No teratogenic effects are reported from any component. |
| Fetal Monitoring | Monitor maternal serum potassium, sodium, glucose, and fluid balance; ECG monitoring if potassium infusion rate exceeds 10 mEq/h; fetal heart rate monitoring if maternal hyperkalemia or hypoglycemia occurs; assess for signs of fluid overload or electrolyte disturbances. |
| Fertility Effects | No known effects on fertility. Use in replacement or maintenance therapy does not impair reproductive function. However, underlying conditions requiring this solution may affect fertility. |
■ FDA Black Box Warning
Do not administer undiluted. Rapid intravenous administration may cause fatal hyperkalemia. Concentrated potassium solutions should be infused via a central line only.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguriaUntreated Addison's diseaseAcute dehydrationCrush syndrome
| Precautions | Use with caution in patients with renal impairment, heart disease, or conditions predisposing to hyperkalemia, Monitor serum potassium, glucose, and electrolytes regularly, Risk of hyperkalemia, especially with rapid infusion, Risk of fluid overload in patients with heart failure or renal impairment, Extravasation risk with concentrated solutions |
| Food/Dietary | Avoid potassium-rich foods (e.g., bananas, oranges, potatoes, spinach, tomatoes, salt substitutes) and high-sodium foods if concurrent hyperkalemia or hypertension is a concern. Dextrose content requires carbohydrate counting in diabetic patients; adjust insulin accordingly. No specific food interactions beyond electrolyte content. |
| Clinical Pearls | Potassium chloride in dextrose 5% and sodium chloride 0.9% provides simultaneous potassium repletion, caloric supplementation, and isotonic volume expansion. Avoid administration at rates exceeding 10-20 mEq/hour via peripheral line to prevent phlebitis; central line preferred for higher rates. Monitor serum potassium, glucose, and sodium levels frequently, especially in renal impairment, diabetes, or heart failure. High dextrose load may cause hyperglycemia; insulin adjustments may be needed in diabetics. NOT compatible with amphotericin B, diazepam, or phenytoin. |
| Patient Advice | This medication is given intravenously to restore potassium levels, provide sugar, and maintain fluid balance. · Inform your doctor if you have kidney disease, diabetes, heart failure, or are on ACE inhibitors, ARBs, or potassium-sparing diuretics. · Report any pain, redness, or swelling at the injection site, muscle weakness, irregular heartbeat, or numbness/tingling. · Do not adjust the infusion rate yourself; it is controlled by healthcare staff. · You may experience increased urination, thirst, or flushing. |
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