Yes

Electrolyte Supplement, Oral

Potassium deficiency; to avoid chloride when high concentration of potassium is needed, source of bicarbonate

C

Severe renal impairment, hyperkalemia

Use with caution in patients with renal disease, hyperkalemia, cardiac disease, metabolic alkalosis; must be administered in patients with adequate urine flow

>10%: Gastrointestinal: Diarrhea, nausea, stomach pain, flatulence, vomiting (oral)

1% to 10%:

Cardiovascular: Bradycardia

Endocrine & metabolic: Hyperkalemia

Neuromuscular & skeletal: Weakness

Respiratory: Dyspnea

Local: Local tissue necrosis with extravasation

<1%: Chest pain, mental confusion, alkalosis, abdominal pain, throat pain, phlebitis, paresthesias, paralysis

Symptoms of overdose include muscle weakness, paralysis, peaked T waves, flattened P waves, prolongation of chloride. QRS complex, ventricular arrhythmias

Removal of potassium can be accomplished by various means; removal through the GI tract with Kayexalate® administration; by way of the kidney through diuresis, mineralocorticoid administration or increased sodium intake; by hemodialysis or peritoneal dialysis; or by shifting potassium back into the cells by insulin and glucose infusion or administration of sodium bicarbonate; calcium chloride will reverse cardiac effects.

Increased effect/levels with potassium-sparing diuretics, salt substitutes, ACE inhibitors

Potassium is the major cation of intracellular fluid and is essential for the conduction of nerve impulses in heart, brain, and skeletal muscle; contraction of cardiac, skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism, and gastric secretion

Absorption: Absorbed well from upper GI tract

Distribution: Enters cells via active transport from extracellular fluid

Elimination: Largely by the kidneys, but also small amount via the skin and feces, with most intestinal potassium being reabsorbed

I.V. doses should be incorporated into the patient's maintenance I.V. fluids, intermittent I.V. potassium administration should be reserved for severe depletion situations and requires EKG monitoring; doses listed as mEq of potassium

Children: 2-5 mEq/kg/day

Adults: 40-100 mEq/day

I.V. intermittent infusion (must be diluted prior to administration):

Children: 0.5-1 mEq/kg/dose (maximum: 30 mEq/dose) to infuse at 0.3-0.5 mEq/kg/hour (maximum: 1 mEq/kg/hour)

Adults: 5-10 mEq/dose (maximum: 40 mEq/dose) to infuse over 2-3 hours (maximum: 40 mEq over 1 hour)

Note: Continuous cardiac monitor recommended for rates >0.5 mEq/hour

Potassium dosage/rate of infusion guidelines:

Serum potassium >2.5 mEq/L: Maximum infusion rate: 10 mEq/hour; maximum concentration: 40 mEq/L; maximum 24-hour dose: 200 mEq

Serum potassium <2.5 mEq/L: Maximum infusion rate: 40 mEq/hour; maximum concentration: 80 mEq/L; maximum 24-hour dose: 400 mEq

Potassium must be diluted prior to parenteral administration; maximum recommended concentration (peripheral line): 80 mEq/L; maximum recommended concentration (central line): 150 mEq/L or 15 mEq/100 mL; in severely fluid-restricted patients (with central lines): 200 mEq/L or 20 mEq/100 mL has been used; maximum rate of infusion, see Usual Dosage, I.V. intermittent infusion

No information available to require special precautions

No effects or complications reported

This form of potassium may only be given I.V. Report immediately any burning or pain at infusion site, chest pain, palpitations, unusual weakness in muscles, tarry stools, or easy bruising.

Supplements usually not needed with adequate diet; EKG should be monitored continuously during the course of highly concentrate potassium solutions

Injection: 2 mEq/mL (20 mL, 50 mL, 100 mL); 4 mEq/mL (50 mL)

Hamill RJ, Robinson LM, Wexler HR, et al, "Efficacy and Safety of Potassium Infusion Therapy in Hypokalemic Critically Ill Patients," Crit Care Med, 1991, 19(5):694-9.

Khilnani P, "Electrolyte Abnormalities in Critically Ill Children," Crit Care Med, 1992, 20(2):241-50.