Potassium Products

Pronunciation: poe-TAS-ee-um
Class: Electrolyte

Trade Names

Effer-K
- Tablets, effervescent potassium 25 mEq (as bicarbonate and citrate)

K-Lor
- Powder, oral potassium chloride 20 mEq/packet

K-Tab
- Tablets, controlled-release potassium chloride 750 mg (equivalent to 10 mEq)

K-Vescent
- Powder, oral potassium and chloride 20 mEq from potassium chloride 1.5 g

Kaon Cl-10
- Tablets, controlled-release potassium chloride 750 mg (equivalent to 10 mEq)

Klor-Con
- Powder, oral potassium chloride 20 mEq/packet
- Powder, oral potassium chloride 25 mEq/packet

Klor-Con 8
- Tablets, controlled-release potassium chloride 600 mg (equivalent to 8 mEq)

Klor-Con 10
- Tablets, controlled-release potassium chloride 750 mg (equivalent to 10 mEq)

Klor-Con/EF
- Tablets, effervescent potassium 25 mEq (as bicarbonate and citrate)

Klor-Con M10
- Tablets, extended-release potassium 10 mEq (from potassium chloride 750 mg)

Klor-Con M15
- Tablets, extended-release potassium 15 mEq (from potassium chloride 1,125 mg)

Klor-Con M20
- Tablets, extended-release potassium 20 mEq (from potassium chloride 1,500 mg)

Micro-K Extencaps
- Capsules, controlled-release microencapsulated potassium chloride 600 mg (equivalent to potassium 8 mEq)
- Capsules, controlled-release microencapsulated potassium chloride 750 mg (equivalent to potassium 10 mEq)

Potassium Chloride
- Liquid, oral potassium, chloride 40 mEq per 15 mL
- 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
- Solution, oral potassium chloride 20 mEq/15mL

Potassium Chloride in 0.45% Sodium Chloride
- Injection, solution 20 mEq/L

Apo-K (Canada)
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 gastric secretion, metabolism, muscle contraction, nerve impulse transmission, and renal function.

Pharmacokinetics

Absorption

Absorbed from the GI tract.

Elimination

Renal (90%), fecal (10%), and a small extent in perspiration.

Indications and Usage

Treatment of hypokalemia with or without metabolic acidosis; prevention of potassium depletion in certain conditions; potassium deficiency states when oral therapy is not adequate or feasible (IV).

Unlabeled Uses

Treatment of thallium poisoning; with anticholinesterase agents in myasthenia gravis; hypokalemia in children.

Contraindications

Acute dehydration; adrenocortical insufficiency; adynamica episodica hereditaria; anuria; diseases in which high potassium levels may be present, including renal failure and conditions in which potassium retention is present; early postoperative oliguria (except during GI drainage); heat cramps; hyperkalemia; severe hemolytic reactions; use of potassium-sparing diuretics; renal impairment; trauma with muscle destruction.

Dosage and Administration

Adults

PO 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.

Infants

PO 2 to 3 mEq/kg in divided doses.

Off-label dosing
Hypokalemia Children

IV 0.5 to 1 mEq/kg/h for 1 to 2 h.

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 oral products after meals or with food and a full glass of water.
  • Mix or dissolve completely oral liquids, soluble powders, or effervescent tablets in 90 to 240 mL 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 bloodstream 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 inhibitors (eg, captopril, enalapril)

Concurrent use may result in elevated serum potassium concentrations by inhibiting aldosterone production. Use concurrently only with close monitoring.

Digitalis

Cardiac arrhythmias may occur with potassium imbalance.

Eplerenone

Concurrent use may increase the risk of hyperkalemia and serious, sometimes fatal, arrhythmias. Concurrent use is contraindicated.

Potassium-sparing diuretics (eg, spirolonactone, triametere, amilnide)

Severe hyperkalemia may occur.

Adverse Reactions

Cardiovascular

ECG abnormalities, fall in BP, cardiac arrhythmias.

CNS

Paresthesias of the extremities, listlessness, mental confusion, weakness and heaviness of the legs.

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, flaccid paralysis of the skeletal muscles, venous thrombosis.

Precautions

Monitor

Monitor serum potassium regularly. Make frequent checks of the clinical status of the patient and periodic ECGs. 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 .

Lactation

Undetermined.

Children

Safety and efficacy not established.

Elderly

Dose selection should be cautious.

Renal Function

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. Potassium intensifies the symptoms of myotonia congenita.

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 the 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 a 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 certain 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 the hands and feet, or unusual fatigue or weakness.

Copyright © 2009 Wolters Kluwer Health.

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