Potassium Salts Potassium acetate, parenteral


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Potassium Salts Potassium acetate, parenteral
Potassium Salts Potassium acetate, parenteral
Potassium Salts
Pregnancy Category: C (Rx)
Potassium acetate, Potassium bicarbonate, and Potassium citrate
(Trikates)
Potassium acetate, Potassium bicarbonate, and Potassium citrate (Tri-K)
Trikates (Tri-K)
Potassium Salts Oral Solution: Tri-K (Rx)
Potassium bicarbonate
Potassium bicarbonate (K + Care ET)
Potassium Salts K + Care ET (Rx)
Potassium bicarbonate and Citric acid
Potassium bicarbonate and Citric acid Effervescent Tablets: K + Care ET
Potassium Salts Klor-Con/EF (Rx)
Potassium bicarbonate and Potassium chloride
Potassium bicarbonate and Potassium chloride
Potassium Salts Effervescent Granules: Neo-K (Rx). Effervescent Tablets: Klorvess K-Lyte/Cl K-Lyte/Cl 50 Potassium-Sandoz (Rx)
Potassium bicarbonate and Potassium citrate
Potassium bicarbonate and Potassium citrate
Potassium Salts Effervescent Tablets: Effer-K Effervescent Potassium K-Lyte (Rx)
Potassium chloride
Potassium chloride (K-Lease)
Potassium Salts Extended-Release Capsules: K-Lease K-Norm Micro-K Extencaps Micro-K 10 Extencaps (Rx). Injection: Potassium Chloride for Injection Concentrate (Rx). Oral Solution: Cena-K 10% and 20% K-10 Kaochlor-10 and -20 Kaochlor 10% Kaochlor S-F 10% Kaon-Cl 20% Liquid Kay Ciel KCl 5% Klorvess 10% Liquid Potasalan Rum-K (Rx). Powder for Oral Solution: Gen-K Kay Ciel K + Care K-Lor Klor-Con Powder Klor-Con/25 Powder K-Lyte/Cl Powder Micro-K LS (Rx). Extended-Release Tablets: Apo-K K + 10 Kalium Durules Kaon-Cl Kaon-Cl-10 K-Dur 10 and 20 K-Long Klor-Con 8 and 10 Klotrix K-Tab Novolente-K Slow-K Slo-Pot 600 Slow-K Ten-K (Rx)
Potassium chloride, Potassium bicarbonate, and Potassium citrate
Potassium chloride, Potassium bicarbonate, and Potassium citrate (Klorvess Effervescent Granules)
Potassium Salts Effervescent Granules: Klorvess Effervescent Granules (Rx)
Potassium gluconate
Potassium gluconate (Kaon)
Potassium Salts Elixir: Kaon Kaylixir K-G Elixir Potassium-Rougier Royonate (Rx). Tablets: Kaon (Rx)
Potassium gluconate and Potassium chloride
Potassium gluconate and Potassium chloride (Kolyum)
Potassium Salts Oral Solution and Powder for Oral Solution: Kolyum (Rx)
Potassium gluconate and Potassium citrate
Potassium gluconate and Potassium citrate (Twin-K)
Potassium Salts Oral Solution: Twin-K (Rx)

Classification: Electrolyte

General Statement Potassium is the major cation of the body's intracellular fluid. It is essential for the maintenance of important physiologic processes, including cardiac, smooth, and skeletal muscle function, acid-base balance, gastric secretions, renal function, protein and carbohydrate metabolism. Symptoms of hypokalemia include weakness, cardiac arrhythmias, fatigue, ileus, hyporeflexia or areflexia, tetany, polydipsia, and, in severe cases, flaccid paralysis and inability to concentrate urine. Loss of potassium is usually accompanied by a loss of chloride resulting in hypochloremic metabolic alkalosis.
The usual adult daily requirement of potassium is 40-80 mg. In adults, the normal extracellular concentration of potassium ranges from 3.5 to 5 mEq/L with the intracellular levels being 150-160 mEq/L. Extracellular concentrations of up to 5.6 mEq/L are normal in children.
Both hypokalemia and hyperkalemia, if uncorrected, can be fatal; thus, potassium must always be administered cautiously.

Action/Kinetics:
Potassium is readily and rapidly absorbed from the GI tract. Though a number of salts can be used to supply the potassium cation, potassium chloride is the agent of choice since hypochloremia frequently accompanies potassium deficiency. Dietary measures can often prevent and even correct potassium deficiencies. Potassium-rich foods include most meats (beef, chicken, ham, turkey, veal), fish, beans, broccoli, brussels sprouts, lentils, spinach, potatoes, milk, bananas, dates, prunes, raisins, avocados, watermelon, cantaloupe, apricots, and molasses.
From 80% to 90% of potassium intake is excreted by the kidney and is partially reabsorbed from the glomerular filtrate.

Uses: PO: Treat hypokalemia due to digitalis intoxication, diabetic acidosis, diarrhea and vomiting, familial periodic paralysis, certain cases of uremia, hyperadrenalism, starvation and debilitation, and corticosteroid or diuretic therapy. Also, hypokalemia with or without metabolic acidosis and following surgical conditions accompanied by nitrogen loss, vomiting and diarrhea, suction drainage, and increased urinary excretion of potassium. Prophylaxis of potassium depletion when dietary intake is not adequate in the following conditions: clients on digitalis and diuretics for CHF, hepatic cirrhosis with ascites, excess aldosterone with normal renal function, significant cardiac arrhythmias, potassium-losing nephropathy, and certain states accompanied by diarrhea. Investigational: Mild hypertension.
NOTE: Use potassium chloride when hypokalemia is associated with alkalosis; potassium bicarbonate, citrate, acetate, or gluconate should be used when hypokalemia is associated with acidosis.
IV: Prophylaxis and treatment of moderate to severe potassium loss when PO therapy is not feasible. Potassium acetate is used as an additive for preparing specific IV formulas when client needs cannot be met by usual nutrient or electrolyte preparations. Potassium acetate is also used in the following conditions: marked loss of GI secretions due to vomiting, diarrhea, GI intubation, or fistulas; prolonged parenteral use of potassium-free fluids (e.g., dextrose or NSS); diabetic acidosis, especially during treatment with insulin and dextrose infusions; prolonged diuresis; metabolic alkalosis; hyperadrenocorticism; primary aldosteronism; overdose of adrenocortical steroids, testosterone, or corticotropin; attacks of hereditary or familial periodic paralysis; during the healing phase of burns or scalds; and cardiac arrhythmias, especially due to digitalis glycosides.

Contraindications: Severe renal function impairment with azotemia or oliguria, postoperatively before urine flow has been reestablished. Crush syndrome, Addison's disease, hyperkalemia from any cause, anuria, heat cramps, acute dehydration, severe hemolytic reactions, adynamia episodica hereditaria, clients receiving potassium-sparing diuretics or aldosterone-inhibiting drugs. Solid dosage forms in clients in whom there is a reason for delay or arrest in passage of tablets through the GI tract.

Special Concerns: Safety during lactation and in children has not been established. Geriatric clients are at greater risk of developing hyperkalemia due to age-related changes in renal function. Administer with caution in the presence of cardiac and renal disease. Potassium loss is often accompanied by an obligatory loss of chloride resulting in hypochloremic metabolic alkalosis; thus, the underlying cause of the potassium loss should be treated.

Side Effects: Hypokalemia. C NS: Dizziness, mental confusion. CV: Arrhythmias; weak, irregular pulse; hypotension, heart block ECG abnormalities, cardiac arrest. GI: Abdominal distention, anorexia, N&V, Neuromuscular: Weakness, paresthesia of extremities, flaccid paralysis, areflexia, muscle or respiratory paralysis weakness and heaviness of legs. Other: Malaise.
Hyperkalemia. C V: Bradycardia, then tachycardia, cardiac arrest. GI: N&V, diarrhea, abdominal cramps, GI bleeding or obstruction. Ulceration or perforation of the small bowel from enteric-coated potassium chloride tablets. GU: Oliguria, anuria. Neuromuscular: Weakness, tingling, paralysis. Other: Skin rashes, hyperkalemia.
Effects due to solution or IV technique used. Fever, infection at injection site, venous thrombosis, phlebitis extending from injection site, extravasation, venospasm, hypervolemia, hyperkalemia.

Overdose Management: Symptoms: Mild (5.5-6.5 mEq/L) to moderate (6.5-8 mEq/L) hyperkalemia (may be asymptomatic except for ECG changes). ECG changes include progression in height and peak of T waves, lowering of the R wave, decreased amplitude and eventually disappearance of P waves, prolonged PR interval and QRS complex, shortening of the QT interval, ventricular fibrillation, death. Muscle weakness that may progress to flaccid quadriplegia and respiratory failure although dangerous cardiac arrhythmias usually occur before onset of complete paralysis. Treatment (plasma potassium levels greater than 6.5 mEq/L): All measures must be monitored by ECG. Measures consist of actions taken to shift potassium ions from plasma into cells by: Sodium bicarbonate: IV infusion of 50-100 mEq over period of 5 min. May be repeated after 10-15 minutes if ECG abnormalities persist. Glucose and insulin: IV infusion of 3 g glucose to 1 unit regular insulin to shift potassium into cells. Calcium gluconate--or other calcium salt (only for clients not on digitalis or other cardiotonic glycosides): IV infusion of 0.5-1 g (5-10 mL of a 10% solution) over period of 2 min. Dosage may be repeated after 1-2 min if ECG remains abnormal. When ECG is approximately normal, the excess potassium should be removed from the body by administration of polystyrene sulfonate, hemodialysis or peritoneal dialysis (clients with renal insufficiency), or other means. Sodium polystyrene sulfonate, hemodialysis, peritoneal dialysis: To remove potassium from the body.

Drug Interactions: ACE inhibitors / May cause potassium retention hyperkalemia Digitalis glycosides / Cardiac arrhythmias Potassium-sparing diuretics / Severe hyperkalemia with possibility of cardiac arrhythmias or arrest

How Supplied: Potassium acetate, parenteral: Injection: 2 mEq/mL, 4 mEq/mL; Potassium acetate, potassium bicarbonate, and potassium citrate: Liquid: 45 mEq/15 mL; Potassium bicarbonate: Tablet, effervescent: 25 mEq, 650 mg; Potassium bicarbonate and potassium citrate: Tablet, effervescent: 25 mEq; Potassium bicarbonate and potassium chloride: Granule for reconstitution: 20 mEq; Tablet, effervescent: 25 mEq, 50 mEq; Potassium chloride: Capsule, extended release: 8 mEq, 10 mEq; Injection: 1.5 mEq/mL, 2 mEq/mL, 10 mEq/50 mL, 10 mEq/100 mL, 20 mEq/50 mL, 20 mEq/100 mL, 30 mEq/100 mL, 40 mEq/100 mL, 100 mEq/L, 200 mEq/L; Liquid: 20 mEq/15 mL, 30 mEq/15 mL, 40 mEq/15 mL; Powder for reconstitution: 20 mEq, 25 mEq, 200 mEq; Tablet: 180 mg; Tablet, extended release: 8 mEq, 10 mEq, 20 mEq; Potassium gluconate: Elixir: 20 mEq/15 mL; Tablet: 486 mg, 500 mg, 550 mg, 595 mg, 610 mg, 620 mg; Tablet, extended release: 595 mg; Potassium gluconate and potassium citrate: Liquid: 20 mEq/15 mL

Dosage
Highly individualized. Oral administration is preferred because the slow absorption from the GI tract prevents sudden, large increases in plasma potassium levels. Dosage is usually expressed as mEq/L of potassium. The bicarbonate, chloride, citrate, and gluconate salts are usually administered PO. The chloride, acetate, and phosphate may be administered by slow IV infusion.
?IV Infusion Serum K less than 2.0 mEq/L.
400 mEq/day at a rate not to exceed 40 mEq/hr. Use a maximum concentration of 80 mEq/L.
Serum K more than 2.5 mEq/L.
200 mEq/day at a rate not to exceed 20 mEq/hr. Use a maximum concentration of 40 mEq/L.
Pediatric: Up to 3 mEq potassium/kg (or 40 mEq/m 2) daily. Adjust the volume administered depending on the body size.
?Effervescent Granules, Effervescent Tablets, Elixir, Extended-Release Capsules, Extended Release Granules, Extended-Release Tablets, Oral Solution, Powder for Oral Solution, Tablets Prophylaxis of hypokalemia.
16-24 mEq/day.
Potassium depletion.
40-100 mEq/day.
NOTE: Usual dietary intake of potassium is 40-250 mEq/day.
For clients with accompanying metabolic acidosis, use an alkalizing potassium salt (potassium bicarbonate, potassium citrate, or potassium acetate).

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