Potassium Products
Pronunciation: (poe-TAS-ee-um)Class: Electrolyte
Trade Names:
Effer-K
- Tablets, effervescent potassium 25 mEq (as bicarbonate and citrate)
Trade Names:
K-Lor
- Powder potassium chloride 20 mEq per packet
Trade Names:
K•Lyte
- Tablets, effervescent potassium 25 mEq (as bicarbonate and citrate)
Trade Names:
K•Lyte DS
- Tablets, effervescent potassium 50 mEq (from potassium bicarbonate and citrate and citric acid)
Trade Names:
K-Tab
- Tablets, controlled-release potassium chloride 750 mg (equiv. to 10 mEq)
Trade Names:
K-Vescent
- Powder potassium and chloride 20 mEq from 1.5 g potassium chloride
Trade Names:
Kaon Cl-10
- Tablets, controlled-release potassium chloride 750 mg (equiv. to 10 mEq)
Trade Names:
Klor-Con
- Powder potassium chloride 20 mEq per packet
- Powder potassium chloride 25 mEq per packet
Trade Names:
Klor-Con 8
- Tablets, controlled-release potassium chloride 600 mg (equiv. to 8 mEq)
Trade Names:
Klor-Con 10
- Tablets, controlled-release potassium chloride 750 mg (equiv. to 10 mEq)
Trade Names:
Klor-Con/EF
- Tablets, effervescent potassium 25 mEq (as bicarbonate and citrate)
Trade Names:
Klor-Con M10
- Tablets, extended-release potassium 10 mEq (from potassium chloride 750 mg)
Trade Names:
Klor-Con M15
- Tablets, extended-release potassium 15 mEq (from potassium chloride 1,125 mg)
Trade Names:
Klor-Con M20
- Tablets, extended-release potassium 20 mEq (from potassium chloride 1,500 mg)
Trade Names:
Klotrix
- Tablets, controlled-release potassium chloride 750 mg (equiv. to 10 mEq)
Trade Names:
Micro-K Extencaps
- Capsules, controlled-release microencapsulated potassium chloride 600 mg (equiv. to potassium 8 mEq)
- Capsules, controlled-release microencapsulated potassium chloride 750 mg (equiv. to potassium 10 mEq)
Trade Names:
Potassium Chloride
- Liquid potassium and chloride 40 mEq per 15 mL
Trade Names:
Potassium Chloride
- Injection, solution, concentrate 2 mEq/mL
- Injection, solution, concentrate 10 mEq
- Injection, solution, concentrate 20 mEq
- Injection, solution, concentrate 30 mEq
- Injection, solution, concentrate 40 mEq
- Injection, solution, concentrate 60 mEq
Trade Names:
Potassium Chloride in 0.45% Sodium Chloride
- Injection, solution 20 mEq/L
K-10 (Canada)
K-Dur (Canada)
K-Lyte (Canada)
K-Lyte/Cl (Canada)
Pharmacology
Major intracellular cation, essential in maintaining acid base balance and isotonicity within cells. Potassium functions in muscle contraction, nerve impulse transmission, gastric secretion, renal function, and metabolism.
Pharmacokinetics
Absorption
Absorbed from the GI tract.
Elimination
Renal (90%), fecal (10%), and a small extent in perspiration.
Indications and Usage
Treatment of hypokalemia; prevention of potassium depletion in certain conditions. Parenterally, as treatment of potassium deficiency states when oral therapy is not adequate or feasible.
Unlabeled Uses
Treatment of thallium poisoning; with anticholinesterase agents in myasthenia gravis.
Contraindications
Severe renal impairment with concomitant azotemia or oliguria; hyperkalemia; diseases in which high potassium levels may be present include renal failure and conditions in which potassium retention is present; anuria; trauma with muscle destruction; severe hemolytic reactions; adrenocortical insufficiency; heat cramps; acute dehydration; adynamica episodica hereditaria; early postoperative oliguria (except during GI drainage); use of potassium-sparing diuretics.
Dosage and Administration
AdultsPO 20 to 100 mEq in divided doses. IV Serum potassium greater than 2.5 mEq/L: Give at a rate not to exceed 10 mEq/h and in a concentration of up to 40 mEq/L; max 200 mEq per 24 h.
Serum potassium less than 2 mEq/L and ECG changes or muscle paralysis: Infuse cautiously at a rate of up to 40 mEq/h; max 400 mEq per 24 h.
InfantsPO 2 to 3 mEq/kg in divided doses.
General Advice
- Do not give tablets to patients who have physical conditions that may slow or stop tablet in GI tract; use properly diluted concentrate form.
- Use whole tablets; do not crush or split tablets. Do not allow patient to chew or suck tablets.
- Administer tablets after meals or with food and full glass of water.
- Mix or dissolve completely oral liquids, soluble powders, or effervescent tablets in 3 to 8 oz of cold water, juice, or other beverage, and have patient drink slowly to minimize GI irritation.
- Patients who have difficulty swallowing capsules may sprinkle the contents onto a spoonful of soft food and swallow immediately. Follow with a glass of water or juice.
- Do not give via IM route or IV push. Administer IV only with a calibrated infusion device at a slow, controlled rate.
- If using a pumping device for administration, discontinue pumping action before the container runs dry, or air embolism may result.
- Rapid infusion may cause local pain; reduce rate to relieve irritation. Whenever possible, administration via a central route is recommended for dilution by the blood stream and avoidance of extravasation.
- Dilute parenteral concentrates before use. Direct injection may be instantly fatal.
Storage/Stability
Store at 68° to 77°F. Protect from freezing. Discard unused portion of pharmacy bulk containers after 4 h.
Drug Interactions
ACE inhibitorsConcurrent use may result in elevated serum potassium concentrations.
DigitalisCardiac arrhythmias may occur with potassium imbalance.
EplerenoneConcurrent use may increase the risk of hyperkalemia and serious, sometimes fatal, arrhythmias. Concurrent use contraindicated.
Potassium-sparing diureticsSevere hyperkalemia may occur.
Laboratory Test Interactions
None well documented.
Adverse Reactions
Dermatologic
Rash.
GI
Abdominal discomfort or distention; diarrhea; flatulence; GI obstruction, bleeding, perforation, or ulceration; nausea; vomiting.
Genitourinary
Anuria, oliguria.
Local
Extravasation, infection at the site of injection, injection-site pain, phlebitis, vein irritation.
Metabolic
Hyperkalemia, hypervolemia.
Miscellaneous
Fever, venous thrombosis.
Precautions
MonitorMonitor serum potassium regularly. Patients requiring highly concentrated solutions should be kept on continuous cardiac monitoring and undergo frequent testing for serum potassium and acid-base balance. |
Pregnancy
Category C (per manufacturer's prescribing information); Category A (per Briggs' Drugs in Pregnancy and Lactation ).
Lactation
Undetermined.
Children
Safety and efficacy not established.
Elderly
Dose selection should be cautious.
Renal Function
IV potassium chloride is contraindicated in patients with renal failure. May cause hyperkalemia in patients with renal insufficiency.
Special Risk Patients
Administer with caution to patients with decreased renal function and in patients with cardiac disease.
Administration
The highly concentrated, ready-to-use potassium chloride injection is intended for use in fluid-restricted patients. Infuse slowly to avoid potassium intoxication.
Aluminum toxicity
Some of these IV products may contain aluminum that may be toxic, especially in patients with renal impairment.
GI lesions
May cause stenotic or ulcerative lesions of the small bowel and death. Discontinue immediately if bowel obstruction or perforation is suspected.
Hyperkalemia
May produce hyperkalemia or cardiac arrest in patients with impaired potassium excretion.
Overdosage
Symptoms
Areflexia, cardiac arrest, cardiac arrhythmias, death, ECG changes, flaccid paralysis, heart block, hypotension, mental confusion, muscle weakness, muscular or respiratory paralysis, paresthesias of the extremities, ventricular fibrillation, weakness.
Patient Information
- Instruct patient to take oral medication after meals or with food and full glass of water.
- Advise patient to swallow tablets whole, without chewing, sucking, or crushing.
- Warn patient not to use salt substitutes and to avoid salt-free food unless approved by health care provider.
- Advise patients taking time-released drug that wax matrix may appear in stool. Emphasize that this is normal.
- Explain importance of avoiding ingestion of large amounts of potassium through excessive intake of foods, such as avocados, bananas, beans, broccoli, dried fruits, grapefruit, nuts, oranges, spinach, sunflower seeds, and tomatoes.
- Instruct patient to promptly report the following symptoms to health care provider: abdominal pain, black stools, confusion, feeling of heaviness in legs, severe nausea or vomiting, tingling of hands and feet, or unusual fatigue or weakness.
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