Yes

Electrolyte Supplement, Oral

Treatment or prevention of hypokalemia

A

Severe renal impairment, untreated Addison's disease, heat cramps, hyperkalemia, severe tissue trauma; solid oral dosage forms are contraindicated in patients in whom there is a structural, pathological, and/or pharmacologic cause for delay or arrest in passage through the GI tract; an oral liquid potassium preparation should be used in patients with esophageal compression or delayed gastric emptying time

Use with caution in patients with cardiac disease, severe renal impairment, hyperkalemia

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

1% to 10%:

Cardiovascular: Bradycardia

Endocrine & metabolic: Hyperkalemia

Local: Local tissue necrosis with extravasation, pain at the site of injection

Neuromuscular & skeletal: Weakness

Respiratory: Dyspnea

<1%: Chest pain, arrhythmias, heart block, hypotension, 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 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 sodium bicarbonate; calcium chloride reverses cardiac effects.

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

Store at room temperature, protect from freezing; use only clear solutions; use admixtures within 24 hours

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 in patients undergoing EKG monitoring.

Premature infants: 2-6 mEq/kg/24 hours

Term infants 0-24 hours: 0-2 mEq/kg/24 hours

Infants >24 hours: 1-2 mEq/kg/24 hours

Children: 2-3 mEq/kg/day

Adults: 40-80 mEq/day

Prevention during diuretic therapy: Oral:

Children: 1-2 mEq/kg/day in 1-2 divided doses

Adults: 20-40 mEq/day in 1-2 divided doses

Treatment of hypokalemia: Children:

Oral: 1-2 mEq/kg initially, then as needed based on frequently obtained lab values. If deficits are severe or ongoing losses are great, I.V. route should be considered.

I.V.: 1 mEq/kg over 1-2 hours initially, then repeated as needed based on frequently obtained lab values; severe depletion or ongoing losses may require >200% of normal limit needs

I.V. intermittent infusion: Dose should not exceed 1 mEq/kg/hour, or 40 mEq/hour; if it exceeds 0.5 mEq/kg/hour, physician should be at bedside and patient should have continuous EKG monitoring; usual pediatric maximum: 3 mEq/kg/day or 40 mEq/m²/day

Treatment of hypokalemia: Adults:

I.V. intermittent infusion: 5-10 mEq/hour (continuous cardiac monitor recommended for rates >5 mEq/hour), not to exceed 40 mEq/hour; usual adult maximum per 24 hours: 400 mEq/day.

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 >2.5 mEq/L:

Oral: 60-80 mEq/day plus additional amounts if needed

I.V.: 10 mEq over 1 hour with additional doses if needed

Potassium <2.5 mEq/L:

Oral: Up to 40-60 mEq initial dose, followed by further doses based on lab values

I.V.: Up to 40 mEq over 1 hour, with doses based on frequent lab monitoring; deficits at a plasma level of 2 mEq/L may be as high as 400-800 mEq of potassium

Administer with plenty of fluid and/or food because of stomach irritation and discomfort

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

Serum potassium, glucose, chloride, pH, urine output (if indicated), cardiac monitor (if intermittent infusion or potassium infusion rates >0.25 mEq/kg/hour)

No information available to require special precautions

No effects or complications reported

Sustained release and wax matrix tablets should be swallowed whole, do not crush or chew; effervescent tablets must be dissolved in water before use; take with food; liquid and granules can be diluted or dissolved in water or juice

Wax matrix tablets must be swallowed and not allowed to dissolve in mouth

Capsule, controlled release (microcapsulated): 600 mg [8 mEq]; 750 mg [10 mEq]

Micro-K® Extencaps®: 600 mg [8 mEq]

K-Lease®, K-Norm®, Micro-K® 10: 750 mg [10 mEq]

Liquid: 10% [20 mEq/15 mL] (480 mL, 4000 mL); 20% [40 mEq/15 mL] (480 mL, 4000 mL)

Cena-K®, Kaochlor®, Kaochlor® SF, Kay Ciel®, Klorvess®, Potasalan®: 10% [20 mEq/15 mL] (480 mL, 4000 mL)

Rum-K®: 15% [30 mEq/15 mL] (480 mL, 4000 mL)

Cena-K®, Kaon-Cl® 20%: 20% [40 mEq/15 mL]

Crystals for oral suspension, extended release (Micro-K® LS®): 20 mEq per packet

Powder: 20 mEq per packet (30s, 100s)

K+ Care®, K-Lor™: 15 mEq per packet (30s, 100s)

Gen-K®, Kay Ciel®, K+ Care®, K-Lor™, Klor-Con®: 20 mEq per packet (30s, 100s)

K+ Care®, Klor-Con/25®: 25 mEq per packet (30s, 100s)

K-Lyte/Cl®: 25 mEq per dose (30s)

Infusion, concentrate: 0.1 mEq/mL, 0.2 mEq/mL, 0.3 mEq/mL, 0.4 mEq/mL

Injection, concentrate: 1.5 mEq/mL, 2 mEq/mL, 3 mEq/mL

Tablet, controlled release (microencapsulated)

K-Dur® 10, Ten-K®: 750 mg [10 mEq]

K-Dur® 20: 1500 mg [20 mEq]

Tablet, controlled release (wax matrix): 600 mg [8 mEq]; 750 mg [10 mEq]

Kaon-Cl®: 500 mg [6.7 mEq]

Klor-Con® 8, Slow-K®: 600 mg [8 mEq]

K+ 10®, Kaon-Cl-10®, Klor-Con® 10, Klotrix®, K-Tab®: 750 mg [10 mEq]

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.