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Pronunciation |
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(poe
TASS ee um AS e
tate) |
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Generic
Available |
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Yes |
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Pharmacological Index |
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Electrolyte Supplement, Oral |
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Use |
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Potassium deficiency; to avoid chloride when high concentration of potassium
is needed, source of bicarbonate |
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Pregnancy Risk
Factor |
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C |
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Contraindications |
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Severe renal impairment, hyperkalemia |
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Warnings/Precautions |
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Use with caution in patients with renal disease, hyperkalemia, cardiac
disease, metabolic alkalosis; must be administered in patients with adequate
urine flow |
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Adverse
Reactions |
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>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 |
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Overdosage/Toxicology |
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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.
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Drug
Interactions |
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Increased effect/levels with potassium-sparing diuretics, salt substitutes,
ACE inhibitors |
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Mechanism of
Action |
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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 |
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Pharmacodynamics/Kinetics |
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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 |
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Usual Dosage |
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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 |
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Administration |
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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 |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Patient
Information |
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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. |
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Nursing
Implications |
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Supplements usually not needed with adequate diet; EKG should be monitored
continuously during the course of highly concentrate potassium
solutions |
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Dosage Forms |
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Injection: 2 mEq/mL (20 mL, 50 mL, 100 mL); 4 mEq/mL (50
mL) |
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References |
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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.
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