potassium chloride + sodium chloride: clinical use

Prescribing considerations

• Confirm that intravenous replacement is necessary and that oral treatment is inadequate.
• Use only in a setting with appropriate infusion-pump, biochemical and ECG monitoring.
• Establish adequate renal function and urine flow before administration.
• Account for concurrent potassium, sodium and fluid intake and medicines affecting electrolyte handling.
• Exercise particular caution with cardiac disease, renal impairment, acidosis, Addison’s disease, shock, extensive tissue injury, chronic hyponatraemia or sodium-restricted states.

Contraindications and cautions

• Hypersensitivity to an active substance or excipient.
• Hyperkalaemia.
• Hyperchloraemia.
• Severe hypernatraemia.
• Severe renal impairment with oliguria or anuria.

Monitoring

• Serum potassium, sodium, chloride and magnesium.
• Renal function and urine output.
• ECG and cardiac rhythm.
• Fluid balance, oedema and acid–base status.
• Central-line position and the infusion site for leakage, pain or inflammation.

Clinical pharmacology

Potassium is predominantly intracellular and central to membrane electrical activity and muscle contraction. Sodium and chloride mainly occupy the extracellular compartment and regulate fluid distribution, osmolality and acid–base balance. The infused electrolytes are fully bioavailable and principally regulated and eliminated by the kidneys.

Formulation and product differences

• The selected product is a hypertonic, glucose-free, high-concentration solution intended only for central venous infusion.
• It is supplied in single-use small-volume bags and must not be mixed with other medicinal products.
• It is not interchangeable in administration requirements with lower-concentration potassium infusion bags that may be suitable for peripheral use.