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(poe-TASS-ee-uhm KLOR-ide)
Cena-K, Effer-K, Gen-K, K + 8, K + 10, K + Care, K + Care ET, K-Dur 10, K-Dur 20, K-G Elixir, K•Lyte, K•Lyte DS, K-Lor, Klorvess, K-Lyte/Cl, K-Lyte/Cl 50, K-Norm, K-Tab, K-vescent Potassium Chloride, Kaochlor 10%, Kaochlor S-F, Kaon, Kaon-Cl, Kaon Cl-10, Kaon-Cl 20%, Kay Ciel, Kaylixir, Klor-Con, Klor-Con 8, Klor-Con 10, Klor-Con/EF, Klor-Con/25, Klorvess, Klotrix, K-Lease, Kolyum, Micro-K Extencaps, Micro-K LS, Rum-K, Slow-K, Ten-K, Tri-K, Twin-K, Potasalan,  APO-K, K-10 Solution, Kalium Durules, Kaochlor-10, Kaochlor-20 Concentrate, K-Lor, Kaoch, Micro-K Extencaps, Roychlor
Class: Electrolyte

 Action Major intracellular cation, essential in maintaining acid base balance and isotonicity within cells. Functions in muscle contraction, nerve impulse transmission, gastric secretion, renal function and metabolism.

 Indications Treatment of hypokalemia; prevention of potassium depletion in certain conditions. Parenterally, as prophylaxis or treatment of moderate-to-severe potassium loss when oral therapy is not adequate or feasible. Unlabeled use(s): Treatment of thallium poisoning; with anticholinesterase agents in myasthenia gravis.

 Contraindications Severe renal impairment with concomitant azotemia or oliguria; hyperkalemia; diseases in which high potassium levels may be present include: renal failure and conditions in which potassium retention is present; anuria; trauma with muscle destruction; severe hemolytic reactions; adrenocortical insufficiency; heat cramps; acute dehydration; adynamica episodica hereditaria; early postoperative oliguria (except during GI drainage); use of potassium-sparing diuretics.

 Route/Dosage

ADULTS: PO 20 to 100 mEq in divided doses. IV 10 to 40 mEq/hr. INFANTS: PO 2 to 3 mEq/kg in divided doses.

 Interactions

Digitalis: Cardiac arrhythmias may occur with potassium imbalance. Potassium-sparing diuretics: Severe hyperkalemia may occur.

 Lab Test Interferences None well documented.

 Adverse Reactions

DERM: Rashes. GI: Abdominal discomfort or distention; GI obstruction; bleeding; ulceration or perforation; nausea; vomiting; flatulence. GU: Oliguria; anuria. OTHER: Hyperkalemia (symptoms may include paresthesia of extremities; listlessness; confusion; weak or heavy limbs; flaccid paralysis; hypotension; arrhythmias; heart block; cardiac arrest; prolonged QT interval; wide QRS complex; peaked T waves; ST depression.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Special-risk patients: Administer with caution to elderly patients or patients with decreased renal function. Use with caution in patients with cardiac disease. GI lesions: May cause stenotic or ulcerative lesions of the small bowel and death. Discontinue immediately if bowel obstruction or perforation is suspected. Hyperkalemia: May produce hyperkalemia or cardiac arrest in patients with impaired potassium excretion.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • Do not give tablets to patients who have physical conditions that may slow or stop tablet in GI track; use properly diluted concentrate form.
  • Use whole tablets; do not crush or split tablets. Do not allow patient to chew or suck tablets.
  • Administer tablets after meals or with food and full glass of water.
  • Mix or dissolve completely oral liquids, soluble powders, or effervescent tablets in 3 to 8 oz of cold water, juice, or other beverage, and have patient drink slowly to minimize GI irritation.
  • Do not give via IM route.
  • Generally, do not begin IV administration until renal flow is established.
  • Do not exceed IV administration rate of 20 mEq/hr and concentration of 40 mEq/L without performing cardiac monitoring. Rapid infusion may cause local pain; reduce rate to relieve irritation.
  • Dilute parenteral concentrates before use. Direct injection may be instantly fatal.
  • Maximum 24 hr dose should not exceed 200 mEq if serum potassium is > 2.5 mEq/L; 400 mEq, if serum potassium is < 2 mEq/L.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note renal cardiac disease, untreated Addison’s disease, dehydration or other conditions that may place patient at risk.
  • Ensure that potassium level has been obtained before beginning therapy. Monitor potassium levels regularly during treatment. Cardiac monitoring is recommended when giving parenteral potassium at rates > 20 mEq/hr.
  • Monitor serum potassium levels closely in patients with renal impairment.
  • Watch for ECG changes such as peaking of T waves, loss of P wave, depression of ST segment, prolongation of QT interval, lengthened P-R interval or widened QRS complex during cardiac monitoring.
  • Observe for overt signs of hyperkalemia: decreased BP, parasthesia, muscle weakness and flaccid paralysis of extremities, listlessness, mental confusion, shock, cardiac arrhythmias, or heart block. Notify physician immediately if these symptoms occur.
  • Observe for phlebitis (IV) and for possible GI distress including abdominal discomfort, nausea, vomiting, and diarrhea. Notify physician if these symptoms occur.
  • Do not abruptly discontinue drug in patients who are also receiving digitalis; digitalis toxicity may occur.
OVERDOSAGE: SIGNS & SYMPTOMS
  ECG changes, ventricular fibrillation, death, muscle weakness that may progress to paralysis of diaphragm

 Patient/Family Education

  • Instruct patient to take oral medication after meals or with food and full glass of water.
  • Advise patient to swallow tablets whole, without chewing, sucking, or crushing.
  • Warn patient not to use salt substitutes and to avoid “salt-free” food unless approved by physician.
  • Advise patients taking time-released drug that wax matrix may appear in stool. Emphasize that this is normal.
  • Explain importance of avoiding ingestion of large amounts of potassium through excessive intake of foods such as avocados, bananas, broccoli, dried fruits, grapefruit, oranges, beans, nuts, spinach, tomatoes, and sunflower seeds.
  • Instruct patient to promptly report the following symptoms to physician: Severe nausea or vomiting, abdominal pain, black stools, tingling of hands and feet, unusual fatigue or weakness, or feeling of heaviness in legs.

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