Potassium Chloride in Dextrose and Sodium Chloride (Page 2 of 4)

Geriatric Use:

An evaluation of current literature revealed no clinical experience identifying differences in response between elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Sodium and potassium ions are known to be substantially excreted by the kidney, and the risk of toxic reactions may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.

ADVERSE REACTIONS

Reactions which may occur because of the solutions or technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation and hypervolemia.

If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures and save the remainder of the fluid for examination if deemed necessary.

Nausea, vomiting, abdominal pain and diarrhea have been reported with potassium therapy. The signs and symptoms of potassium intoxication include paresthesias of the extremities, flaccid paralysis, listlessness, mental confusion, weakness and heaviness of the legs, hypotension, cardiac arrhythmias, heart block, electrocardiographic abnormalities such as disappearance of P waves, spreading and slurring of the QRS complex with development of a biphasic curve and cardiac arrest.

Potassium-containing solutions are intrinsically irritating to tissues. Therefore, extreme care should be taken to avoid perivascular infiltration. Local tissue necrosis and subsequent sloughing may result if extravasation occurs. Chemical phlebitis and venospasm have also been reported.

Should perivascular infiltration occur, I.V. administration at that site should be discontinued at once. Local infiltration of the affected area with procaine hydrochloride, 1%, to which hyaluronidase may be added, will often reduce venospasm and dilute the potassium remaining in the tissues locally. Local application of heat may also be helpful.

OVERDOSAGE

In the event of potassium overdosage, discontinue the infusion immediately and institute intensive corrective therapy to reduce serum potassium levels. See WARNINGS and PRECAUTIONS .

DOSAGE AND ADMINISTRATION

These solutions should be administered only by intravenous infusion and as directed by the physician. The dose and rate of injection are dependent upon the age, weight and clinical condition of the patient. If the serum potassium level is greater than 2.5 mEq/liter, potassium should be given at a rate not to exceed 10 mEq/hour in a concentration less than 30 mEq/liter. Somewhat faster rates and greater concentrations (usually up to 40 mEq/liter) of potassium may be indicated in patients with more severe potassium deficiency. The total 24-hour dose should not generally exceed 200 mEq of potassium.

As reported in the literature, the dosage and constant infusion rate of intravenous dextrose must be selected with caution in pediatric patients, particularly neonates and low birth weight infants, because of the increased risk of hyperglycemia/hypoglycemia.

Drug Interactions

Additives may be incompatible. Consult with pharmacist, if available. When introducing additives, use aseptic technique, mix thoroughly and do not store.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. See PRECAUTIONS .

INSTRUCTIONS FOR USE

To Open

Tear outer wrap at notch and remove solution container. If supplemental medication is desired, follow directions below before preparing for administration. Some opacity of the plastic due to moisture absorption during the sterilization process may be observed. This is normal and does not affect the solution quality or safety. The opacity will diminish gradually.

To Add Medication

  1. Prepare additive port.
  2. Using aseptic technique and an additive delivery needle of appropriate length, puncture resealable additive port at target area, inner diaphragm and inject. Withdraw needle after injecting medication.
  3. The additive port may be protected by covering with an additive cap.
  4. Mix container contents thoroughly.

Preparation for Administration

(Use aseptic technique)

  1. Close flow control clamp of administration set.
  2. Remove cover from outlet port at bottom of container.
  3. Insert piercing pin of administration set into port with a twisting motion until the set is firmly seated. NOTE: See full directions on administration set carton.
  4. Suspend container from hanger.
  5. Squeeze and release drip chamber to establish proper fluid level in chamber.
  6. Open flow control clamp and clear air from set. Close clamp.
  7. Attach set to venipuncture device. If device is not indwelling, prime and make venipuncture.
  8. Regulate rate of administration with flow control clamp.

WARNING: Do not use flexible container in series connections.

HOW SUPPLIED

Intravenous solutions with potassium chloride (I.V. solution with KCl) are supplied in single-dose flexible plastic containers. See Tables:

TABLE 1

Potassium Chloride

in 5% Dextrose and

0.225% Sodium

Chloride Inj., USP

COMPOSITION (g/L)

Approx. Ionic Concentrations (mEq/L)

mEq

Potassium

Size

(mL)

Dextrose,

Hydrous

Sodium

Chloride

Potassium

Chloride

Calculated

Osmolarity

(mOsmol/L)

pH

Sodium

(Na+)

Potassium

(K+)

Chloride

(Cl)

Approximate

kcal/L

NDC NO.

10 mEq

1000

50

2.25

0.745

349

4.2

(3.5 to 6.5)

38.5

10

48.5

170

0409-7997-09

10 mEq

500

50

2.25

1.49

370

4.2

(3.5 to 6.5)

38.5

20

58.5

170

0409-7901-03

20 mEq

1000

50

2.25

1.49

370

4.2

(3.5 to 6.5)

38.5

20

58.5

170

0409-7901-09

30 mEq

1000

50

2.25

2.24

389

4.2

(3.5 to 6.5)

38.5

30

68.5

170

0409-7991-09

40 mEq

1000

50

2.25

2.98

409

4.2

(3.5 to 6.5)

38.5

40

78.5

170

0409-7992-09

TABLE 2

Potassium Chloride

in 5% Dextrose and

0.3% Sodium

Chloride Inj., USP

COMPOSITION (g/L)

Approx. Ionic Concentrations (mEq/L)

mEq

Potassium

Size

(mL)

Dextrose,

Hydrous

Sodium

Chloride

Potassium

Chloride

Calculated

Osmolarity

(mOsmol/L)

pH

Sodium

(Na+)

Potassium

(K+)

Chloride

(Cl)

Approximate

kcal/L

NDC NO.

10 mEq

500

50

3.0

1.49

395

4.2

(3.5 to 6.5)

51

20

71

170

0409-7998-03

20 mEq

1000

50

3.0

1.49

395

4.2

(3.5 to 6.5)

51

20

71

170

0409-7998-09

TABLE 3

Potassium Chloride

in 5% Dextrose and

0.45% Sodium

Chloride Inj., USP

COMPOSITION (g/L)

Approx. Ionic Concentrations (mEq/L)

mEq

Potassium

Size

(mL)

Dextrose,

Hydrous

Sodium

Chloride

Potassium

Chloride

Calculated

Osmolarity

(mOsmol/L)

pH

Sodium

(Na+)

Potassium

(K+)

Chloride

(Cl)

Approximate

kcal/L

NDC NO.

10 mEq

1000

50

4.5

0.745

426

4.2

(3.5 to 6.5)

77

10

87

170

0409-7993-09

10 mEq

500

50

4.5

1.49

447

4.2

(3.5 to 6.5)

77

20

97

170

0409-7902-03

20 mEq

1000

50

4.5

1.49

447

4.2

(3.5 to 6.5)

77

20

97

170

0409-7902-09

30 mEq

1000

50

4.5

2.24

467

4.2

(3.5 to 6.5)

77

30

107

170

0409-7903-09

40 mEq

1000

50

4.5

2.98

487

4.2

(3.5 to 6.5)

77

40

117

170

0409-7904-09

TABLE 4

Potassium Chloride

in 5% Dextrose and

0.9% Sodium

Chloride Inj., USP

COMPOSITION (g/L)

Approx. Ionic Concentrations (mEq/L)

mEq

Potassium

Size

(mL)

Dextrose,

Hydrous

Sodium

Chloride

Potassium

Chloride

Calculated

Osmolarity

(mOsmol/L)

pH

Sodium

(Na+)

Potassium

(K+)

Chloride

(Cl)

Approximate

kcal/L

NDC

NO.

20 mEq

1000

50

9

1.49

600

4.2

(3.5 to 6.5)

154

20

174

170

0409-7107-09

40 mEq

1000

50

9

2.98

640

4.2

(3.5 to 6.5)

154

40

194

170

0409-7109-09


May contain HCl for pH adjustment.

Store at 20 to 25°C (68 to 77°F). [See USP Controlled Room Temperature.]

Protect from freezing.

Revised: April, 2009

Printed in USA EN-2100

Hospira, Inc., Lake Forest, IL 60045 USA

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