Potassium Chloride

Potassium Chloride

ADMINISTRATION ROUTES:

• IV

ALTERNATIVE NAMES:

• Potassium Chloride, chlorvescent, slow K, span K

ICU INDICATIONS:

1. hypokalaemia

PRESENTATION AND ADMINISTRATION:

• IV:
  750mg/10ml (1mmol/ml) ampoules
  Add 10-20mmol KCl to 100ml of compatible IV fluid and infuse over 1 hour via a central line. Rates of up to 40mmol/hr have be used via central line for severe hypokalaemia (<2mmol/L) when cardiac abnormalities were present
  When infused via a peripheral vein, it is preferable to use a concentration of not greater than 40mmol/L. Consider whether oral or NG replacement is possible.
  When KCl has been added to IV fluids or when commercial preparations are opened, discard any solution not used within 24 hours. Do not use cloudy solutions.
  Compatible with the following IV fluids:
  0.9% sodium chloride, Hartmanns, 5%, 10% & 20% glucose, Glucose and sodium chloride
  Store at room temperature

• PO:
  Chlorvescent Effervescent tablets (each contains 14mmol of potassium)
  Span K sustained release tablets (each contains 8mmol of potassium)

DOSAGE:

• IV:
  For cardiac patients: <4mmol give 20mmol KCl; if <4.5 give 10mmol KCl
  For non cardiac patients usually <3.5mmol give 20mmol KCl; <4.0mmol give 10mmol KCl

• PO:
  Dose according to requirements and response.

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

• Dose in renal impairment [GFR (ml/min)]
  <10: dose according to response
  10-20: dose according to response
  20-50: dose according to response
• Dose in renal replacement therapy
  CAPD: dose according to response
  HD: dose according to response
  CVVHDF: dose according to response

DOSAGE IN PAEDIATRICS:

• IV:
  Deficiency: usually 0.3mmol/kg/hr (max 0.4mmol/kg/hr) for 4-6 hours IV, then 4mmol/kg/ day
  Max oral dose 1mmol/kg (<5years); 0.5mmol/kg (>5years).
  If given peripherally via IV route, max 0.05mmol/ml

CLINICAL PHARMACOLOGY:

• The potassium ion is the principal intracellular cation of most body tissues. Potassium ions participate in a number of essential physiological processes including the maintenance of intracellular tonicity, the transmission of nerve impulses, the contraction of cardiac, skeletal and smooth muscle and the maintenance of normal renal function.

CONTRAINDICATIONS:

1. hyperkalaemia

WARNINGS

• In patients with impaired mechanisms for excreting potassium, the administration of potassium salts can produce hyperkalemia and cardiac arrest.

PRECAUTIONS

• General:
  Solid oral dosage forms of potassium chloride can produce ulcerative and/or stenotic lesions of the gastrointestinal tract.
• Laboratory Tests: No tests in addition to routine ICU tests are required.
• Drug/Laboratory Test Interactions:None known

IMPORTANT DRUG INTERACTIONS FOR THE ICU

• Simultaneous administration of ACE inhibitors or potassium sparing diuretics (eg spironolactone) with KCl may lead to hyperkalaemia.

ADVERSE REACTIONS

• Body as a Whole: Hyperkalaemia
• Gastrointestinal system (with oral preparations): GI upset, ulcer, perforation, bleeding
• Local: Injection site pain