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Product Name
:
POTASSIUM CHLORIDE ELSaad
Chemical Name
:
Potassium Chloride
Therapeutic Category
:
Fluids and Electrolytes
Pharmacologic Category
:
Electrolyte Supplement, Parenteral
Pharmaceutical Form
:
Ampoule
Composition
:
Potassium Chloride 10% / 15% / 20%
Dosing
 
Dosing: Adult
I.V. doses should be incorporated into the patient's maintenance I.V. fluids; intermittent I.V. potassium administration should be reserved for severe depletion situations in patients undergoing ECG monitoring. Doses expressed as mEq of potassium.
Normal daily requirements: I.V.: 40-80 mEq/day
Treatment of hypokalemia:
I.V. intermittent infusion: Peripheral or central line: ≤10 mEq/hour; repeat as needed based on frequently obtained lab values; central line infusion and continuous ECG monitoring highly recommended for infusions >10 mEq/hour.
Potassium dosage/rate of infusion general guidelines (per product labeling): Note: High variability exists in dosing/infusion rate recommendations; therapy guided by patient condition and specific institutional guidelines.
Serum potassium >2.5 mEq/L: Maximum infusion rate: 10 mEq/hour; maximum concentration: 40 mEq/L; maximum 24-hour dose: 200 mEq
Serum potassium <2 mEq/L and symptomatic (excluding emergency treatment of cardiac arrest): Maximum infusion rate (central line only): 40 mEq/hour in presence of continuous ECG monitoring and frequent lab monitoring; In selected situations, patients may require up to 400 mEq/24 hours.

Dosing: Pediatric

I.V. doses should be incorporated into the patient's maintenance I.V. fluids; intermittent I.V. potassium administration should be reserved for severe depletion situations in patients undergoing ECG monitoring. Doses expressed as mEq of potassium.
Normal daily requirements: Oral, I.V.: 1-2 mEq/kg/day
Treatment of hypokalemia:
I.V. intermittent infusion: 0.5-1 mEq/kg/dose (maximum dose: 40 mEq). If infusion exceeds 0.5 mEq/kg/hour, physician should be at bedside and patient should have continuous ECG monitoring; repeat as needed based on frequently obtained lab values.

Dosing: Geriatric

Refer to adult dosing.
Use
 
Treatment or prevention of hypokalemia
Adverse Reactions
 
Frequency not defined.
Dermatologic: Rash
Endocrine & metabolic: Hyperkalemia
Gastrointestinal: Abdominal pain/discomfort, diarrhea, flatulence, GI bleeding (oral), GI obstruction (oral), GI perforation (oral), nausea, vomiting
Contraindications
 
Hypersensitivity to any component of the formulation; hyperkalemia. In addition, solid oral dosage forms are contraindicated in patients in whom there is a structural, pathological, and/or pharmacologic cause for delay or arrest in passage through the GI tract.
Warnings / Precautions Drug
 
Concerns related to adverse effects:
• Hyperkalemia: Close monitoring of serum potassium concentrations is needed to avoid hyperkalemia; severe hyperkalemia may lead to muscle weakness/paralysis and cardiac conduction abnormalities (eg, heart block, ventricular arrhythmias, asystole).
Disease-related concerns:
• Acid/base disorders: Use with caution in patients with acid/base alterations; changes in serum potassium concentrations can occur during acid/base correction, monitor closely.
• Cardiovascular disease: Use with caution in patients with cardiovascular disease (eg, heart failure, cardiac arrhythmias); patients may be more susceptible to life-threatening cardiac effects associated with hyper/hypokalemia.
• Potassium-altering conditions/disorders: Use with caution in patients with disorders or conditions likely to contribute to altered serum potassium and hyperkalemia (eg, untreated Addison's disease, heat cramps, severe tissue breakdown from trauma or burns).
• Renal impairment: Use with caution in patients with renal impairment; monitor serum potassium concentrations closely. Contraindicated with severe impairment.
Concurrent drug therapy issues:
• Digitalis: Use with caution in digitalized patients; may be more susceptible to potentially life-threatening cardiac effects with rapid changes in serum potassium concentrations.
• Potassium-altering therapies: Use with caution in patients receiving concomitant medications or therapies that increase potassium (eg, ACEI, potassium-sparing diuretics, potassium containing salt substitutes).
Other warnings/precautions:
• Parenteral administration: Use extreme caution with parenteral administration and monitor serum potassium concentrations closely. Evaluate renal function, cardiac and fluid status, and any factors contributing to altered potassium concentrations (eg, acidosis, alkalosis) prior to therapy. Do NOT administer undiluted or I.V. push; inappropriate parenteral administration may be fatal. Always administer potassium further diluted; refer to appropriate dilution and administration rate recommendations. Pain and phlebitis may occur during parenteral infusion requiring a decrease in infusion rate or potassium concentration. Avoid administering potassium diluted in dextrose solutions during initial therapy; potential for transient decreases in serum potassium due to intracellular shift of potassium from dextrose-stimulated insulin release.
Interactions
 
ACE Inhibitors: Potassium Salts may enhance the hyperkalemic effect of ACE Inhibitors. Risk C: Monitor therapy
Angiotensin II Receptor Blockers: Potassium Salts may enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy
Anticholinergic Agents: May enhance the ulcerogenic effect of Potassium Chloride. Risk D: Consider therapy modification
Eplerenone: May enhance the hyperkalemic effect of Potassium Salts. Management: This combination is contraindicated in patients receiving eplerenone for treatment of hypertension. Risk D: Consider therapy modification
Glycopyrrolate: May enhance the adverse/toxic effect of Potassium Chloride. This is specific to solid oral dosage forms of potassium chloride. Management: Concurrent use of solid oral dosage forms of potassium chloride are contraindicated with glycopyrrolate. Consider using a non-solid oral dosage form or another alternative therapy as appropriate. Risk X: Avoid combination
Potassium-Sparing Diuretics: Potassium Salts may enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk D: Consider therapy modification
Pregnancy
 
C
Pregnancy Implications
Reproduction studies have not been conducted. Potassium supplementation (that does not cause maternal hyperkalemia) would not be expected to cause adverse fetal events.
Lactation
 
Enters breast milk/compatible
Breast-Feeding Considerations
The normal content of potassium in human milk is ∼13 mEq/L. Supplementation (that does not cause maternal hyperkalemia) would not be expected to affect normal levels.
Monitoring Parameters
 
Serum potassium, chloride, magnesium (to facilitate potassium repletion), cardiac monitor (if intermittent infusion or potassium infusion rates 0.5 mEq/kg/hour in children or >10 mEq/hour in adults); to assess adequate replacement, repeat serum potassium level 2-4 hours after dose
Reference Range
Note: Reference ranges may vary depending on the laboratory
Serum potassium: 3.5-5.2 mEq/L
Mechanism of Action
 
Potassium is the major cation of intracellular fluid and is essential for the conduction of nerve impulses in heart, brain, and skeletal muscle; contraction of cardiac, skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism, and gastric secretion
Pharmacodynamics / Kinetics
 
Distribution: Enters cells via active transport from extracellular fluid
Excretion: Primarily urine; skin and feces (small amounts); most intestinal potassium reabsorbed
 
   
 
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