Potassium Chloride

Uses
Hypokalaemia

Contraindications
Severe renal failure
Severe tissue trauma
Untreated Addison’s disease

Administration
IV infusion: 20 mmol in 50 ml sodium chloride 0.9% or glucose 5% via central line or undiluted via central line. Prefilled bags should preferably be used where possible

Potassium chloride 1.5 g (20 mmol K+) in 10-ml ampoules Concentrations greater than 40 mmol in 1 l should be administered
centrally, though concentrations up to 80 mmol/l can be administered via a large peripheral vein

IV infusion: undiluted via central line

Do not give at >20 mmol/h
Monitor serum potassium regularly
Check serum magnesium in refractory hypokalaemia

How not to use potassium
Do not infuse neat potassium chloride into a peripheral vein Avoid extravasation and do not give IM or SC (severe pain and tissue necrosis)
Do not use neat potassium chloride to reconstitute antibiotics as this has inadvertently caused several deaths

Adverse effects
Muscle weakness
Arrhythmias
ECG changes

Cautions
Renal impairment
Concurrent use of potassium-sparing diuretics or ACE-I
Hypokalaemia is frequently associated with hypomagnesaemia

Organ failure
Renal: risk of hyperkalaemia

Renal replacement therapy
Potassium accumulates in renal failure. Removed by HD/HF/PD.
Treat hypokalaemia only on the basis of measured serum levels