potassium supplements (parenteral)

Contraindicated in:

Hyperkalemia;
Severe renal impairment;
Untreated Addison’s disease;
Severe tissue trauma;
Hyperkalemic familial periodic paralysis;
Potassium acetate injection contains aluminum, which may become toxic with prolonged use to high risk groups (renal impairment, premature neonates).

Use Cautiously in:

Cardiac disease;
Renal impairment;
Hypomagnesemia (may make correction of hypokalemia more difficult);
Patients receiving potassium-sparing drugs.

Adv. Reactions/Side Effects ⬆ ⬇

CV: ECG changes, ARRHYTHMIAS

Local: irritation at IV site

Neuro: confusion, paralysis, paresthesia, restlessness, weakness

Interactions ⬆ ⬇

Drug-drug:

Use with potassium-sparing diuretics or ACE inhibitors or angiotensin II receptor antagonists may lead to hyperkalemia.
Anticholinergics may ↑ GI mucosal lesions in patients taking wax-matrix potassium chloride preparations.

Availability ⬆ ⬇

Potassium Acetate

(Generic available)

Concentrate for injection (contains aluminum): 2 mEq/mL in 20-, 50-, and 100-mL vials; 4 mEq/mL in 50-mL vials

Potassium Chloride

(Generic available)

Concentrate for injection: 0.1 mEq/mL in 10-mEq ampules and vials; 0.2 mEq/mL in 10- and 20-mEq ampules and vials; 0.3 mEq/mL in 30-mEq ampules and vials; 0.4 mEq/mL in 20- and 40-mEq ampules and vials; 1.5 mEq/mL; 2 mEq/mL; 3 mEq/mL
Solution for IV infusion: 10 mEq/L in various dextrose and saline solutions in 250-, 500-, and 100-mL containers; 20 mEq/L in dextrose/saline/LRs in 250-, 500-, and 100-mL containers; 30 mEq/L in various dextrose and saline solutions in 250-, 500-, and 100-mL containers; 40 mEq/L in various dextrose and saline solutions in 250-, 500-, and 100-mL containers

Route/Dosage ⬆ ⬇

Expressed as mEq of potassium. Potassium acetate contains 10.2 mEq/g; potassium chloride contains 13.4 mEq potassium/g.

Normal Daily Requirements

IV (Adults ): 40–80 mEq/day.
IV (Children ): 2–3 mEq/kg/day.
IV (Neonates ): 2–6 mEq/kg/day.

Treatment of Hypokalemia

IV (Adults ): 10–20 mEq/dose (maximum: 40 mEq/dose) to infuse over 2–3 hr (maximum infusion rate: 40 mEq/hr).
IV (Neonates , Infants and Children): 0.5–1 mEq/kg/dose (maximum 30 mEq/dose) as an infusion to infuse at 0.3–0.5 mEq/kg/hr (maximum infusion rate 1 mEq/kg/hr).

Action ⬆ ⬇

Maintain acid-base balance, isotonicity, and electrophysiologic balance of the cell.
Activator in many enzymatic reactions; essential to transmission of nerve impulses; contraction of cardiac, skeletal, and smooth muscle; gastric secretion; renal function; tissue synthesis; and carbohydrate metabolism.

Therapeutic effects:

Replacement.
Prevention of deficiency.

Classifications ⬆ ⬇

Therapeutic Classification: mineral and electrolyte replacements/supplements

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed following oral administration.

Distribution: Enters extracellular fluid; then actively transported into cells.

Metabolism/Excretion: Excreted by the kidneys.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

(increase in serum potassium levels)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	1–2 hr	unknown
IV	rapid	end of infusion	unknown

Patient/Family Teaching ⬆ ⬇

Advise patient regarding sources of dietary potassium (see Food Sources for Specific Nutrients). Encourage compliance with recommended diet.
Instruct patient to report dark, tarry, or bloody stools; weakness; unusual fatigue; or tingling of extremities. Notify health care professional if nausea, vomiting, diarrhea, or stomach discomfort persists. Dosage may require adjustment.
Emphasize the importance of regular follow-up exams to monitor serum levels and progress.

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Indications ⬇

Contraind./Precautions ⬆ ⬇