Drugs List

Therapeutic Indications

Uses

Electrolyte imbalance
Hypokalaemia - severe
Rehydration in patients with high carbohydrate need
Severe hypoglycaemia

Prevention and treatment of potassium depletion and/or hypokalaemia in cases where supply of water, potassium chloride and carbohydrates is required due to restricted fluid and electrolyte intake via normal routes.

Supply of potassium and carbohydrate during parenteral nutrition.

Prevention and treatment of hypoglycaemia.

Rehydration in case of water loss and dehydration states in patients with high carbohydrate need.

Administration

For slow intravenous infusion only.

Contraindications

Baseline serum potassium above 5 mmol/L
Diabetic hyperosmolar coma
Impaired glucose tolerance
Oedema
Addison's disease
Anuria
Cardiac failure
Diabetes insipidus
Hepatic cirrhosis with ascites
Hyperchloraemia
Hyperglycaemia
Hyperlactataemia
Hypervolaemia
Oliguria
Severe renal impairment
Uncontrolled diabetes mellitus

Precautions and Warnings

Acute illness
Burns
Cardiopulmonary disorder
Children under 18 years
Females of childbearing potential
Recent head trauma
Shock
Adrenal insufficiency
Breastfeeding
Cardiac disorder
Chronic alcoholism
Diabetes mellitus
Gastrointestinal disorder
Hepatic impairment
Hyperaldosteronism
Metabolic alkalosis
Pregnancy
Recent cerebrovascular accident
Renal impairment
Severe dehydration
Severe malnutrition
Thyrotoxicosis

Reduce dose in patients with renal impairment
Avoid rapid infusion rates
Do not give blood products in same intravenous line
Diabetic control may need adjustment
Ensure adequate hydration prior to infusion
Monitor acid-base balance
Monitor blood / urinary glucose concentrations in diabetic patients
Monitor children closely for signs and symptoms of hyponatraemia
Monitor creatinine, blood urea nitrogen (BUN) and urinary output
Monitor ECG
Monitor fluid and electrolyte status
Monitor renal function in patients with renal impairment
Monitor serum glucose in newborns
Monitor serum potassium regularly
Discontinue if hypersensitivity reactions occur

Intravenous potassium should be administered via a large peripheral or central vein to reduce the risk of causing sclerosis. If infused through a central vein, ensure that the catheter is not in the atrium of ventricle in order to avoid localised hyperkalaemia.

The intravenous infusion device and administration equipment must be frequently monitored.

If hyperglycaemia occurs during therapy, reduce the rate of infusion or administer insulin.

Do not use plastic containers connected in series as this can result in air embolism. This is due to residual air being drawn from the primary container before the administration of the fluid from the secondary container is completed.

Acute hyponatraemia can lead to acute hyponatraemic encephalopathy. Children, women in the fertile age, patients with brain oedema or with reduced cerebral compliance are all at particular risk of life threatening brain swelling caused by acute hyponatraemia.

Pregnancy and Lactation

Pregnancy

Use potassium chloride in glucose 10% with caution during pregnancy.

The manufacturer advises caution if potassium chloride in glucose 10% is used during pregnancy as it may result in foetal hyperglycaemia and metabolic acidosis as well as rebound neonatal hypoglycaemia due to foetal insulin production.

Hyperkalaemic and hypokalaemic states lead to impaired cardiac function of the maternal and foetal hearts. Maternal electrolyte levels must therefore be controlled regularly.

Potassium chloride in glucose 10% should be used with caution if administered in combination with oxytocin due to the risk of hyponatraemia.

Lactation

Use potassium chloride in glucose 10% with caution during breastfeeding.

The manufacturer advises caution if potassium chloride in glucose 10% is used when breastfeeding. There presence of potassium chloride in glucose 10% in human breast milk and the effects on exposed infants are unknown. The potential risk and benefits for each specific patient should be carefully considered prior to administration.

Side Effects

Anaphylactic reaction
Cardiac arrest
Chills
Electrolyte disturbances
Extravasation
Glycosuria
Hyperglycaemia
Hyperkalaemia
Hypersensitivity reactions
Hypervolaemia
Hypokalaemia
Hyponatraemia
Irritation (injection site)
Local infection at injection site
Over-hydration
Pain / soreness (injection site)
Phlebitis (injection site)
Pyrexia

Presentation

Infusion containing potassium chloride and glucose 10%.

Drugs List

Therapeutic Indications

Uses

Electrolyte imbalance
Hypokalaemia - severe
Rehydration in patients with high carbohydrate need
Severe hypoglycaemia

Prevention and treatment of potassium depletion and/or hypokalaemia in cases where supply of water, potassium chloride and carbohydrates is required due to restricted fluid and electrolyte intake via normal routes.

Supply of potassium and carbohydrate during parenteral nutrition.

Prevention and treatment of hypoglycaemia.

Rehydration in case of water loss and dehydration states in patients with high carbohydrate need.

Dosage

Adults

Children

Patients with Renal Impairment

Administration

For slow intravenous infusion only.

Contraindications

Baseline serum potassium above 5 mmol/L
Diabetic hyperosmolar coma
Impaired glucose tolerance
Oedema
Addison's disease
Anuria
Cardiac failure
Diabetes insipidus
Hepatic cirrhosis with ascites
Hyperchloraemia
Hyperglycaemia
Hyperlactataemia
Hypervolaemia
Oliguria
Severe renal impairment
Uncontrolled diabetes mellitus

Precautions and Warnings

Acute illness
Burns
Cardiopulmonary disorder
Children under 18 years
Females of childbearing potential
Recent head trauma
Shock
Adrenal insufficiency
Breastfeeding
Cardiac disorder
Chronic alcoholism
Diabetes mellitus
Gastrointestinal disorder
Hepatic impairment
Hyperaldosteronism
Metabolic alkalosis
Pregnancy
Recent cerebrovascular accident
Renal impairment
Severe dehydration
Severe malnutrition
Thyrotoxicosis

Reduce dose in patients with renal impairment
Avoid rapid infusion rates
Do not give blood products in same intravenous line
Diabetic control may need adjustment
Ensure adequate hydration prior to infusion
Monitor acid-base balance
Monitor blood / urinary glucose concentrations in diabetic patients
Monitor children closely for signs and symptoms of hyponatraemia
Monitor creatinine, blood urea nitrogen (BUN) and urinary output
Monitor ECG
Monitor fluid and electrolyte status
Monitor renal function in patients with renal impairment
Monitor serum glucose in newborns
Monitor serum potassium regularly
Discontinue if hypersensitivity reactions occur

Intravenous potassium should be administered via a large peripheral or central vein to reduce the risk of causing sclerosis. If infused through a central vein, ensure that the catheter is not in the atrium of ventricle in order to avoid localised hyperkalaemia.

The intravenous infusion device and administration equipment must be frequently monitored.

If hyperglycaemia occurs during therapy, reduce the rate of infusion or administer insulin.

Do not use plastic containers connected in series as this can result in air embolism. This is due to residual air being drawn from the primary container before the administration of the fluid from the secondary container is completed.

Acute hyponatraemia can lead to acute hyponatraemic encephalopathy. Children, women in the fertile age, patients with brain oedema or with reduced cerebral compliance are all at particular risk of life threatening brain swelling caused by acute hyponatraemia.

Pregnancy and Lactation

Pregnancy

Use potassium chloride in glucose 10% with caution during pregnancy.

The manufacturer advises caution if potassium chloride in glucose 10% is used during pregnancy as it may result in foetal hyperglycaemia and metabolic acidosis as well as rebound neonatal hypoglycaemia due to foetal insulin production.

Hyperkalaemic and hypokalaemic states lead to impaired cardiac function of the maternal and foetal hearts. Maternal electrolyte levels must therefore be controlled regularly.

Potassium chloride in glucose 10% should be used with caution if administered in combination with oxytocin due to the risk of hyponatraemia.

Lactation

Use potassium chloride in glucose 10% with caution during breastfeeding.

The manufacturer advises caution if potassium chloride in glucose 10% is used when breastfeeding. There presence of potassium chloride in glucose 10% in human breast milk and the effects on exposed infants are unknown. The potential risk and benefits for each specific patient should be carefully considered prior to administration.

Side Effects

Anaphylactic reaction
Cardiac arrest
Chills
Electrolyte disturbances
Extravasation
Glycosuria
Hyperglycaemia
Hyperkalaemia
Hypersensitivity reactions
Hypervolaemia
Hypokalaemia
Hyponatraemia
Irritation (injection site)
Local infection at injection site
Over-hydration
Pain / soreness (injection site)
Phlebitis (injection site)
Pyrexia

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: November 2020.

Reference Sources

Summary of Product Characteristics: Potassium chloride 0.15% w/v and glucose 10% w/v solution for infusion. Baxter Healthcare Ltd. Revised October 2019.