potassium chloride

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potassium chloride

Classes

Alkalinizing Agents
Carbohydrate IV Solutions and Additives, more than 10%
Electrolytes with Carbohydrate Solutions
Potassium Supplements
Sodium Chloride Solutions with Potassium
Supplemental Dietary Agents

Administration
Oral Administration Oral Solid Formulations

Administer with a full glass of water (or other liquid) with or immediately after food.

Adverse Reactions
Severe

hyperkalemia / Delayed / Incidence not known
AV block / Early / Incidence not known
bradycardia / Rapid / Incidence not known
muscle paralysis / Delayed / Incidence not known
ventricular fibrillation / Early / Incidence not known
asystole / Rapid / Incidence not known
arrhythmia exacerbation / Early / Incidence not known
cardiac arrest / Early / Incidence not known

Moderate

hypotension / Rapid / Incidence not known
confusion / Early / Incidence not known
dyspnea / Early / Incidence not known

Mild

hyporeflexia / Delayed / Incidence not known
weakness / Early / Incidence not known
fatigue / Early / Incidence not known
anxiety / Delayed / Incidence not known
paresthesias / Delayed / Incidence not known
nausea / Early / Incidence not known
vomiting / Early / Incidence not known
flatulence / Early / Incidence not known
diarrhea / Early / Incidence not known
abdominal pain / Early / Incidence not known
rash / Early / Incidence not known

Common Brand Names

Cena K, Effer-K, Epiklor, K Plus, K Plus Care ET, K-Dur, K-Lor, K-Lyte, K-Sol, K-Tab, K-Vescent, Kaon-CL, Kay Ciel, Klor-Con, Klor-Con EF, Klor-Con M10, Klor-Con M15, Klor-Con M20, Klotrix, Micro-K, Micro-K Extencaps, Slow-K

Dea Class

OTC, Rx

Description

Potassium is primary intracellular cation
Dietary supplement used to maintain potassium balance (i.e., hypokalemia prevention)
Guidelines recommend that serum potassium concentrations of at least 4 mEq/L be achieved and maintained in patients with hypertension, heart failure, and cardiac arrhythmias

Dosage And Indications
For nutritional supplementation to maintain potassium balance (i.e., hypokalemia prevention). Oral dosage Adults

1 to 2 tablets PO daily. The recommended adequate intake (AI) of potassium (from all sources, including food) in healthy individuals is 4.7 g/day PO; 5.1 g/day PO is recommended for lactating women.

Dosing Considerations
Hepatic Impairment

Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed.

Renal Impairment

Dosage should be modified depending on clinical response and degree of renal impairment, but no quantitative recommendations are available. Monitor serum potassium concentrations and renal function carefully to avoid development of hyperkalemia.

Drug Interactions

Monograph content under development

How Supplied

Cena K/Kaon-CL/Kay Ciel/K-Sol/Potassium Chloride Oral Sol: 15mL, 20mEq, 40mEq
Effer-K/K Plus Care ET/Klor-Con EF/K-Lyte/K-Vescent/Potassium Bicarbonate/Potassium Bicarbonate, Potassium Chloride Oral Tab Effrv: 25mEq, 10-0.84g, 20-1.68g, 25-1.5g
Epiklor/K Plus/Kay Ciel/K-Lor/Klor-Con/K-Sol/Potassium Chloride Oral Pwd F/Recon: 20mEq, 25mEq
K-Dur/Klor-Con/Klor-Con M10/Klor-Con M15/Klor-Con M20/Klotrix/K-Tab/Potassium Chloride/Slow-K Oral Tab ER: 8mEq, 10mEq, 15mEq, 20mEq
Klor-Con/Micro-K/Micro-K Extencaps/Potassium Chloride Oral Cap ER: 8mEq, 10mEq
Potassium Acetate/Potassium Chloride/Potassium Chloride, Dextrose/Potassium Chloride, Dextrose, Sodium Chloride/Potassium Chloride, Sodium Chloride Intravenous Inj Sol: 1mL, 2mEq, 4mEq, 10mEq, 20mEq, 30mEq, 40mEq, 50mL, 100mL, 10-5-0.225%, 10-5-0.45%, 20-0.45%, 20-0.9%, 20-5%, 20-5-0.2%, 20-5-0.225%, 20-5-0.3%, 20-5-0.45%, 20-5-0.9%, 30-5%, 30-5-0.225%, 30-5-0.45%, 40-0.9%, 40-5%, 40-5-0.225%, 40-5-0.45%, 40-5-0.9%
Potassium Oral Tab: 83mg, 99mg

Maximum Dosage
Adults

Tolerable upper limit not established; usual Max dose as a dietary supplement is 2 tablets/day PO.

Geriatric

Tolerable upper limit not established; usual Max dose as a dietary supplement is 2 tablets/day PO.

Adolescents

Safety and efficacy have not been established.

Children

Safety and efficacy have not been established.

Infants

Safety and efficacy have not been established.

Neonates

Safety and efficacy have not been established.

Mechanism Of Action

Potassium is actively transported into cells through a process facilitated by dextrose, insulin, and oxygen. Transport maintains a high potassium gradient across cell membranes, thus playing a vital role in electrical excitability of nerves and muscle. Relatively high intracellular potassium concentrations leads to passive diffusion out of the cell. The membrane gradient is responsible for the resting transmembrane electric potential, primarily determined by the diffusion of potassium out of the cell. Membrane depolarization will occur only when a current is applied to the nerve that exceeds the outward potassium current. This is usually accomplished by sodium rushing into the cell by fast inward channels, causing the action or 'spike' potential. Repolarization is partially but quickly attained by potassium flowing out of the cell through its own channel.
Hydrogen ions are also in higher concentration inside cells. When the extracellular hydrogen ion concentration is increased, as occurs in acidosis, potassium shifts to the extracellular environment; when it is decreased, potassium ions move into the cells. Hypo- or hyperkalemia can initiate changes in concentration of other ions. In the former state, when potassium becomes depleted, as the ion leaves the cell it is exchanged with extracellular sodium and hydrogen ions to maintain electroneutrality. The redistribution of hydrogen ions causes intracellular acidosis and extracellular alkalosis. The opposite happens in hyperkalemia.
Within or near the normal range of potassium balance, the ion plays a part in regulating renal synthesis of ammonia and in the pH of urine. A decrease in dietary intake of potassium stimulates renal synthesis of ammonia and increases urinary pH slightly by diminishing net acid secretion. If potassium loss is low, metabolic acidosis results. Greater potassium loss can cause systemic metabolic alkalosis and intracellular acidosis. Tubular secretion of potassium is inhibited by acidemia and stimulated by alkalemia.

Pharmacokinetics

Potassium gluconate is administered orally. Potassium first enters the extracellular fluid and is then actively transported into cells. Skeletal muscle accounts for the bulk of the intracellular store of potassium. Renal excretion of potassium normally is equal to the amount being absorbed in the diet. Potassium is freely filtered at the glomerulus and almost completely reabsorbed in the proximal tubule. Tubular secretion occurs in the late distal convoluted tubule and collecting duct, and accounts for the potassium excreted in the urine, which is about 10% of the amount filtered. Fecal elimination of potassium is minimal and plays no significant role in potassium homeostasis.
 
Affected cytochrome P450 isoenzymes: none

Pregnancy And Lactation
Pregnancy

There are no adequate, well controlled studies with potassium supplements in pregnant women and animal reproduction studies have not been conducted. Therefore, it is unknown whether potassium gluconate can cause fetal harm when administered during pregnancy. Use potassium gluconate during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Although data are limited, potassium supplements appear to be safe and effective to use during breast-feeding to help meet maternal nutritional requirements. The normal potassium ion content of human milk is about 13 mEq/L. Because exogenous potassium becomes part of the body potassium pool, so long as body potassium is not excessive, potassium supplementation should have little or no effect on the concentration in human milk.