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Potassium chloride

Classification

Electrolyte supplement

Indications

CCP: Hypokalemia

CCP: Diabetic ketoacidosis / hyperosmolar hyperglycemic syndrome

Contraindications

Hypersensitivity
Hyperkalemia
Renal failure
Untreated Addison’s disease
Concomitant use with triamterene and amiloride.

Adult dosages

10 mEq of KCL increases serum potassium levels approximately 0.1 mEq/L

CCP: Hypokalemia

Up to 10 mEq/hr IV (max dose of 10 mEq/hr up to 200 mEq/day)
If K is < 2 mEq/L with ECG changes and/or muscle paralysis a max dose of 40 mEq/hr up to 400 mEq/day

Pediatric Considerations And Dosing

CCP: Hypokalemia (severe)

Infants, Children, and Adolescents: Intermittent IV infusion

0.5-1 mEq/kg/dose; maximum dose: 40 mEq/dose; infuse at a rate ≤ 0.5 mEq/kg/hour

Mechanism Of Action

Potassium chloride replenishes a major intracellular cation potassium. Potassium is involved in various physiologic processes such as nerve impulse conduction, cardiac, skeletal, and smooth muscle contraction.

Pharmacokinetics

Half-life: unknown

Adverse Effects

Hyperkalemia
Fluid overload
Arrhythmias
GI obstruction
GI ulceration
GI perforation
GI bleeding (solid dose form)
Refeeding syndrome
Nausea
Vomiting
Abdominal discomfort
Diarrhea
Dyspepsia
Hyponatremia
Hyponatremic encephalopathy

Warning And Precautions

Depending on volume and rate of IV infusion, and the patient’s underlying condition electrolyte disturbances and overhydration are possible.
Solutions containing sodium ions should be used with care where the clinical states indicate sodium retention.
Monitor patients with severe renal impairment for the development of adverse reactions.
Sodium-containing solutions should be administered with caution to patients receiving corticosteroids or other salt-retaining patients.
Potassium levels are not necessarily indicative of tissue potassium levels.
Closely monitor pediatric patients who may have impaired ability to regulate fluids and electrolytes.
Extravasation may cause tissue damage, which may be severe. Care is required as nerve, tendon, and vascular damage has occurred and may require amputation.

Drug Interactions

Eplerenone
Amiloride
Baloxavir marboxil
Drospirenone
Oxybutynin
Potassium acid phosphate
Potassium citrate
Potassium phosphates
Spironolactone
Triamterene
Aliskiren
Angiotensin-Converting Enzyme Inhibitors
Anticholinergic Agents
Finerenone
Glycopyrrolate
Heparins
Nicorandil
Potassium-Sparing Diuretics