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Pot Chl/d5w 10meq/l Inj, 1000ml

Manufacturer FRESENIUS KABI USA Active Ingredient Intravenous (IV) Fluids(in truh VEE nuhs FLOO ids) Pronunciation POH-tass-ee-um KLOR-ide / DEX-trohs in WAH-ter
It is used to give fluids to the body when more fluids and electrolytes are needed.It is used as a way to give other drugs as a shot.It may be given to you for other reasons. Talk with the doctor.
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Drug Class
Fluid, electrolyte, and nutrient replenisher
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Pharmacologic Class
Intravenous solution; Electrolyte; Carbohydrate
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Pregnancy Category
Category C
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FDA Approved
Jan 1970
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DEA Schedule
Not Controlled

Overview

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What is this medicine?

This medication is an intravenous (IV) fluid that provides your body with water, sugar (dextrose), and an important electrolyte called potassium. It's used to help keep your body hydrated, provide some energy, and maintain proper levels of potassium, which is vital for your heart, muscles, and nerves to work correctly.
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How to Use This Medicine

Proper Use of This Medication

To use this medication correctly, follow your doctor's instructions and read all the information provided. This medication is administered as an infusion into a vein over a period of time. Your doctor may instruct you on how to self-administer this medication.

Before and after handling the medication, wash your hands thoroughly. Do not use the medication if the solution appears cloudy, is leaking, or contains particles. Additionally, do not use the solution if it has changed color.

To dispose of used needles and other sharp objects, use a needle/sharp disposal box. Never reuse needles or other items. When the disposal box is full, follow local regulations for proper disposal. If you have any questions or concerns, consult your doctor or pharmacist.

Storage and Disposal

Typically, this medication is administered in a hospital or doctor's office. If you need to store it at home, follow the storage instructions provided by your doctor.

Missed Dose

If you miss a dose, contact your doctor to determine the best course of action.
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Lifestyle & Tips

  • Report any unusual symptoms immediately, such as muscle weakness, tingling, numbness, or changes in heart rate.
  • Inform your healthcare provider about all medications you are taking, including over-the-counter drugs, supplements, and herbal products, as some can interact with potassium levels.
  • Your doctor will monitor your blood tests frequently to ensure the right balance of fluids and electrolytes.
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Available Forms & Alternatives

Available Strengths:

Dosing & Administration

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Adult Dosing

Standard Dose: Highly individualized based on patient's fluid, electrolyte, and acid-base balance, and clinical condition. Typical maintenance: 20-40 mEq potassium per day. For repletion: Infusion rate should not exceed 10 mEq/hour in peripheral veins, or 20 mEq/hour in central veins with continuous ECG monitoring.

Condition-Specific Dosing:

maintenance_fluid_therapy: Typically 10-20 mEq/L in maintenance IV fluids, infused at rates appropriate for fluid balance (e.g., 80-125 mL/hour).
hypokalemia_repletion: Dose and rate depend on severity of hypokalemia and patient's renal function. Higher concentrations (e.g., 20-40 mEq/L) may be used, but this specific product is 10 mEq/L.
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Pediatric Dosing

Neonatal: Not established for this specific concentration as a standard. Dosing is highly individualized based on weight, fluid status, and electrolyte needs. Typically 1-2 mEq/kg/day for maintenance, not exceeding 0.5-1 mEq/kg/hour.
Infant: Highly individualized based on weight, fluid status, and electrolyte needs. Typically 1-2 mEq/kg/day for maintenance, not exceeding 0.5-1 mEq/kg/hour.
Child: Highly individualized based on weight, fluid status, and electrolyte needs. Typically 1-2 mEq/kg/day for maintenance, not exceeding 0.5-1 mEq/kg/hour.
Adolescent: Highly individualized based on weight, fluid status, and electrolyte needs. Typically 1-2 mEq/kg/day for maintenance, not exceeding 0.5-1 mEq/kg/hour.
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Dose Adjustments

Renal Impairment:

Mild: Use with caution; monitor serum potassium closely.
Moderate: Significant dose reduction required; monitor serum potassium and renal function frequently. Risk of hyperkalemia is increased.
Severe: Contraindicated or used with extreme caution and continuous ECG monitoring due to high risk of life-threatening hyperkalemia. Consider alternative routes or therapies.
Dialysis: Generally contraindicated in anuric patients or those with severe renal failure not on dialysis. If on dialysis, potassium supplementation is typically managed by dialysis prescription and oral intake, not IV fluids unless specifically indicated and closely monitored.

Hepatic Impairment:

Mild: No specific adjustment required, but monitor fluid and electrolyte balance as liver disease can affect these.
Moderate: No specific adjustment required, but monitor fluid and electrolyte balance as liver disease can affect these.
Severe: No specific adjustment required, but monitor fluid and electrolyte balance as liver disease can affect these, especially in cases of ascites or edema.

Pharmacology

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Mechanism of Action

Potassium Chloride (KCl) provides potassium ions, which are essential for the maintenance of intracellular tonicity, nerve impulse transmission, cardiac contraction, and skeletal and smooth muscle function. It is a major intracellular cation. Dextrose 5% in Water (D5W) provides a source of calories (170 kcal/L) and free water. Dextrose is metabolized to carbon dioxide and water, making the solution effectively hypotonic in vivo, which helps in hydrating cells and preventing ketosis.
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Pharmacokinetics

Absorption:

Bioavailability: 100% (intravenous)
Tmax: Rapid (immediate distribution upon infusion)
FoodEffect: Not applicable (IV administration)

Distribution:

Vd: Potassium distributes throughout total body water, with approximately 98% being intracellular. Dextrose distributes throughout the extracellular and intracellular fluid compartments.
ProteinBinding: Not applicable for potassium or dextrose.
CnssPenetration: Yes (both potassium and dextrose cross the blood-brain barrier)

Elimination:

HalfLife: Potassium: Not a fixed half-life; depends on intake, excretion, and cellular shifts. Dextrose: Rapidly metabolized.
Clearance: Potassium: Primarily renal (glomerular filtration and tubular secretion/reabsorption). Dextrose: Metabolized.
ExcretionRoute: Potassium: Urine (primarily), feces, sweat. Dextrose: Metabolites (CO2 via lungs, water via kidneys).
Unchanged: Potassium: Varies based on physiological needs. Dextrose: None (fully metabolized).
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Pharmacodynamics

OnsetOfAction: Immediate (upon intravenous infusion)
PeakEffect: Within minutes to hours, depending on infusion rate and patient's physiological state.
DurationOfAction: Varies depending on patient's metabolic state, renal function, and ongoing losses. Effects are sustained as long as infusion continues and potassium balance is maintained.

Safety & Warnings

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Side Effects

Serious Side Effects: Seek Medical Help Immediately

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention right away:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
 Signs of fluid and electrolyte problems, such as:
+ Mood changes
+ Confusion
+ Muscle pain or weakness
+ Fast or abnormal heartbeat
+ Severe dizziness or passing out
+ Increased thirst
+ Seizures
+ Feeling very tired or weak
+ Decreased appetite
+ Unable to pass urine or change in the amount of urine produced
+ Dry mouth
+ Dry eyes
+ Severe upset stomach or vomiting
Signs of skin infection, such as:
+ Oozing
+ Heat
+ Swelling
+ Redness
+ Pain
 Swelling, warmth, numbness, change of color, or pain in a leg or arm
Chest pain or pressure
 Fever
Shortness of breath
 Significant weight gain
Swelling in the arms or legs

Other Possible Side Effects

Like all medications, this drug can cause side effects. Many people experience no side effects or only mild ones. If you notice any of the following side effects or any other symptoms that concern you, contact your doctor:

 Irritation or swelling at the injection site
* Pain at the injection site

This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
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Seek Immediate Medical Attention If You Experience:

  • Muscle weakness or paralysis
  • Tingling or numbness in hands or feet
  • Slow or irregular heartbeat (palpitations)
  • Shortness of breath or difficulty breathing
  • Swelling in your ankles, feet, or hands
  • Confusion or dizziness
  • Pain, redness, or swelling at the IV site
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Before Using This Medicine

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
 All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor and pharmacist identify potential interactions between this medication and other substances you are taking.
* Any existing health problems, as this medication may interact with certain conditions.

To ensure your safety, it is crucial to verify that it is safe to take this medication with all your current medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
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Precautions & Cautions

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

If your medication contains potassium, consult your doctor before using any salt substitutes or products that also contain potassium.

If your medication contains dextrose and you have diabetes (high blood sugar), discuss this with your doctor to ensure safe management of your condition.

Regular blood tests will be necessary as directed by your doctor. Be sure to follow their instructions and discuss any concerns or questions you may have.

When administering this medication to newborns, exercise caution, as the risk of side effects may be increased in this age group.

If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor. They will help you weigh the benefits and risks of this medication to both you and your baby, ensuring an informed decision about its use.
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Overdose Information

Overdose Symptoms:

  • Hyperkalemia (high potassium levels): muscle weakness, flaccid paralysis, paresthesias, confusion, cardiac arrhythmias (bradycardia, asystole, ventricular fibrillation), ECG changes (peaked T waves, prolonged PR, widened QRS).
  • Fluid overload: peripheral edema, pulmonary edema, dyspnea, hypertension, congestive heart failure.

What to Do:

Immediately stop the infusion. Management of hyperkalemia may include IV calcium gluconate (for cardiac protection), insulin and dextrose (to shift potassium intracellularly), sodium bicarbonate, loop diuretics, or dialysis. Management of fluid overload involves diuretics and fluid restriction. Call 1-800-222-1222 (Poison Control) or seek immediate medical attention.

Drug Interactions

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Contraindicated Interactions

  • Potassium-sparing diuretics (e.g., spironolactone, amiloride, triamterene) in patients with impaired renal function or significant hyperkalemia risk.
  • ACE inhibitors (e.g., lisinopril, enalapril) and Angiotensin Receptor Blockers (ARBs) (e.g., valsartan, losartan) in patients with impaired renal function or significant hyperkalemia risk.
  • Aliskiren (direct renin inhibitor) in patients with impaired renal function or significant hyperkalemia risk.
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Major Interactions

  • Potassium-sparing diuretics (increased risk of severe hyperkalemia).
  • ACE inhibitors/ARBs (increased risk of hyperkalemia, especially in renal impairment).
  • Nonsteroidal Anti-inflammatory Drugs (NSAIDs) (may impair renal potassium excretion, increasing hyperkalemia risk).
  • Cyclosporine, Tacrolimus (may increase serum potassium).
  • Digoxin (hyperkalemia can reduce digoxin effect; hypokalemia potentiates digoxin toxicity, so careful balance is needed).
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Moderate Interactions

  • Beta-blockers (may impair cellular uptake of potassium, leading to higher serum levels).
  • Heparin (may cause hypoaldosteronism, leading to hyperkalemia).
  • Succinylcholine (may cause acute increase in serum potassium, especially in patients with neuromuscular disease or trauma).

Monitoring

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Baseline Monitoring

Serum Electrolytes (Potassium, Sodium, Chloride, Magnesium, Calcium, Phosphate)

Rationale: To establish baseline electrolyte status and identify pre-existing imbalances before initiating therapy.

Timing: Prior to initiation of infusion.

Renal Function (BUN, Serum Creatinine, GFR)

Rationale: To assess kidney's ability to excrete potassium and guide dosing, as renal impairment significantly increases hyperkalemia risk.

Timing: Prior to initiation of infusion.

Fluid Status (Weight, Vital Signs, Edema assessment)

Rationale: To assess hydration status and risk of fluid overload.

Timing: Prior to initiation of infusion.

Electrocardiogram (ECG)

Rationale: To assess for pre-existing cardiac abnormalities and establish a baseline for monitoring potassium's effect on cardiac conduction.

Timing: Prior to initiation, especially if hypokalemia is severe or patient has cardiac history.

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Routine Monitoring

Serum Potassium

Frequency: Every 4-6 hours initially, then daily or as clinically indicated, especially during rapid repletion or in patients with renal impairment.

Target: 3.5-5.0 mEq/L

Action Threshold: Below 3.5 mEq/L (consider increasing rate/concentration if indicated); Above 5.0 mEq/L (reduce/stop infusion, investigate cause, consider treatment for hyperkalemia).

Serum Sodium, Chloride, Magnesium, Phosphate

Frequency: Daily or as clinically indicated.

Target: Within normal limits

Action Threshold: Significant deviations require intervention.

Renal Function (BUN, Creatinine)

Frequency: Daily or every other day, especially in patients with changing renal function.

Target: Stable or improving

Action Threshold: Rising levels indicate worsening renal function, requiring re-evaluation of potassium dose.

Fluid Balance (Intake/Output, Daily Weight)

Frequency: Every 4-8 hours (I/O), daily (weight).

Target: Balanced I/O, stable weight (unless fluid shifts are desired).

Action Threshold: Positive fluid balance, rapid weight gain, or signs of fluid overload (e.g., crackles, edema) require intervention.

Electrocardiogram (ECG)

Frequency: Continuous monitoring during rapid infusion or in patients at high risk for hyperkalemia/hypokalemia, otherwise daily or as clinically indicated.

Target: Normal rhythm and conduction.

Action Threshold: Peaked T waves, prolonged PR interval, widened QRS (hyperkalemia); U waves, flattened T waves, ST depression (hypokalemia) require immediate intervention.

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Symptom Monitoring

  • Signs of hyperkalemia: muscle weakness, paresthesias, flaccid paralysis, bradycardia, cardiac arrhythmias (palpitations, irregular heartbeat).
  • Signs of hypokalemia (if inadequate repletion): muscle weakness, cramps, fatigue, constipation, cardiac arrhythmias.
  • Signs of fluid overload: peripheral edema, pulmonary crackles, dyspnea, jugular venous distension, hypertension.
  • Signs of infusion site reactions: pain, redness, swelling, phlebitis.

Special Patient Groups

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Pregnancy

Generally considered safe when clinically indicated for fluid and electrolyte management, but close monitoring of maternal fluid and electrolyte balance is essential. Potassium requirements may increase during pregnancy.

Trimester-Specific Risks:

First Trimester: No known specific risks beyond general fluid/electrolyte management.
Second Trimester: No known specific risks beyond general fluid/electrolyte management.
Third Trimester: No known specific risks beyond general fluid/electrolyte management. Monitor for fluid overload, especially in pre-eclampsia.
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Lactation

Potassium and dextrose are natural components of breast milk. Administration of this solution is generally considered safe during lactation when clinically indicated, as it is unlikely to cause adverse effects in the breastfed infant.

Infant Risk: Low risk.
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Pediatric Use

Dosing must be highly individualized based on weight, age, fluid status, and electrolyte needs. Children, especially neonates and infants, have less developed renal function and are more susceptible to fluid and electrolyte imbalances. Close monitoring of serum electrolytes, glucose, and fluid balance is critical.

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Geriatric Use

Elderly patients are at increased risk for renal impairment, which can lead to hyperkalemia with potassium supplementation. They are also more susceptible to fluid overload and electrolyte imbalances. Close monitoring of renal function, fluid status, and serum electrolytes is essential. Start with lower doses and titrate carefully.

Clinical Information

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Clinical Pearls

  • NEVER administer undiluted potassium chloride intravenously. Always ensure it is adequately diluted in an appropriate IV fluid.
  • Infuse potassium-containing solutions slowly. Rapid infusion can cause fatal hyperkalemia.
  • Always verify the concentration of potassium in the IV bag before administration to prevent medication errors.
  • Continuous ECG monitoring is recommended for infusion rates exceeding 10 mEq/hour or in patients at high risk for hyperkalemia.
  • Assess renal function (BUN, creatinine, urine output) before and during potassium administration, as impaired renal function is the primary risk factor for hyperkalemia.
  • Monitor serum magnesium levels, as hypomagnesemia can make hypokalemia refractory to potassium repletion.
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Alternative Therapies

  • Oral potassium supplements (for mild to moderate hypokalemia or maintenance)
  • Other intravenous fluids (e.g., 0.9% Sodium Chloride, Lactated Ringer's) for hydration when potassium supplementation is not needed or is provided separately.
  • Potassium phosphate (for combined hypokalemia and hypophosphatemia).
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Cost & Coverage

Average Cost: $5 - $20 per 1000ml bag
Generic Available: Yes
Insurance Coverage: Tier 1 (Generic)
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General Drug Facts

If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly; do not flush them down the toilet or pour them down the drain unless instructed to do so by a healthcare professional or pharmacist. If you are unsure about the correct disposal method, consult with your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the quantity, and the time it was taken to ensure timely and appropriate treatment.