ASHP INJECTABLE DRUG INFORMATION Potassium CHLORIDE 1311 Potassium Chloride AHFS 40:12 Products chloride injection thoroughly with the infusion solution before administration. The usual maximum concentration is 40 mEq/L. Potassium chloride is available as concentrated solutions of 1.5 and Extravasation should be avoided.1(5/06) 4 2 mEq/mL in 10-, 20-, 30-, and 40-mEq sizes in water for injection in ampuls, vials, and syringes. It is also available in a 30-mL (60-mEq) Great care is required when adding potassium chloride to multiple-dose vial containing methylparaben 0.05% and propyl- infusion solutions, whether in flexible plastic containers or paraben 0.005% as preservatives and 250-mL pharmacy bulk pack- in rigid bottles. Adding potassium chloride to running infu- ages. The pH may have been adjusted with hydrochloric acid and sion solutions hanging in the use position, especially in flex- if necessary potassium hydroxide during manufacture. The concen- ible containers, has resulted in the pooling of potassium chlo- trated solutions must be diluted for use.1(5/06) ride and a resultant high-concentration bolus of the drug being administered to patients, with serious and even fatal conse- Potassium chloride is also available premixed in infusion 4 quences. Attempts to mix adequately the potassium chloride solutions in concentrations of 10, 20, 30, and 40 mEq/L. in flexible containers by squeezing the container in the hanging pH position were unsuccessful. It is recommended that drugs be The pH is usually near 4.6 with a range from 4 to 8.1(5/06) 17 admixed with solutions in flexible containers when positioned with the injection arm of the container uppermost. With both Osmolarity rigid bottles and flexible containers, subsequent repeated inver- The injections are very hypertonic; the 2-mEq/mL concentra- sion and agitation to effect thorough mixture are necessary.85 130 tion has an osmolarity of 4000 mOsm/L. The injection must be 454 455 456 714 715 1127 1778 2151 diluted for use.1(5/06) Osmolality Stability The solution should be stored at controlled room temperature The osmolality of potassium chloride (Abbott) 2 mEq/mL was and used only if it is clear.1(5/06) determined to be 4355 mOsm/kg by freezing-point depression and 3440 mOsm/kg by vapor pressure.1071 Potassium chloride injection 80 mEq/L added to dextrose 5% contained in glass bottles results in a leaching of precipitates The osmolality of a potassium chloride 7.5% solution was consisting of silica and alumina.129 determined to be 1895 mOsm/kg.1233 Administration Potassium chloride in the concentrated injections must be diluted before slow intravenous administration. Mix potassium Compatibility Information Solution Compatibility Potassium chloride Test Soln Name Mfr Mfr Conc/L or % Remarks Ref C/I Dextrose 2.5% in half-strength Ringer’s injection AB AB 160 mEq Physically compatible 3 C Dextrose 5% in Ringer’s injection AB AB 160 mEq Physically compatible 3 C Dextrose 5% in half-strength Ringer’s injection, AB AB 160 mEq Physically compatible 3 C lactated Dextrose 2.5% in Ringer’s injection, lactated AB AB 160 mEq Physically compatible 3 C Dextrose 5% in Ringer’s injection, lactated AB AB 160 mEq Physically compatible 3 C Dextrose 5% in Ringer’s injection, lactated BA LI 80 mEq Physically compatible for 24 hr 315 C Dextrose 10% in Ringer’s injection, lactated AB AB 160 mEq Physically compatible 3 C Dextrose 2.5% in sodium chloride 0.45% AB AB 160 mEq Physically compatible 3 C DOI: 10.37573/9781585286850.322 1312 Potassium CHLORIDE ASHP INJECTABLE DRUG INFORMATION Solution Compatibility (Cont.) Test Soln Name Mfr Mfr Conc/L or % Remarks Ref C/I Dextrose 2.5% in sodium chloride 0.9% AB AB 160 mEq Physically compatible 3 C Dextrose 5% in sodium chloride 0.225% AB AB 160 mEq Physically compatible 3 C Dextrose 5% in sodium chloride 0.45% AB AB 160 mEq Physically compatible 3 C Dextrose 5% in sodium chloride 0.9% AB AB 160 mEq Physically compatible 3 C Dextrose 5% in sodium chloride 0.9% 3 g Physically compatible 74 C Dextrose 5% in sodium chloride 0.9% BA LI 80 mEq Physically compatible for 24 hr 315 C Dextrose 10% in sodium chloride 0.9% AB AB 160 mEq Physically compatible 3 C Dextrose 2.5% AB AB 160 mEq Physically compatible 3 C Dextrose 5% 3 g Physically compatible 74 C Dextrose 5% AB AB 160 mEq Physically compatible 3 C Dextrose 5% BA LI 80 mEq Physically compatible for 24 hr 315 C Dextrose 10% AB AB 160 mEq Physically compatible 3 C Dextrose 10% BA LI 80 mEq Physically compatible for 24 hr 315 C Dextrose 20% BA LI 80 mEq Physically compatible for 24 hr 315 C Ionosol B in dextrose 5% AB AB 160 mEq Physically compatible 3 C Ionosol MB in dextrose 5% AB AB 160 mEq Physically compatible 3 C Ringer’s injection AB AB 160 mEq Physically compatible 3 C Ringer’s injection 3 g Physically compatible 74 C Ringer’s injection, lactated AB AB 160 mEq Physically compatible 3 C Ringer’s injection, lactated BA LI 80 mEq Physically compatible for 24 hr 315 C Sodium chloride 0.45% AB AB 160 mEq Physically compatible 3 C Sodium chloride 0.9% 3 g Physically compatible 74 C Sodium chloride 0.9% AB AB 160 mEq Physically compatible 3 C Sodium chloride 0.9% BA LI 80 mEq Physically compatible for 24 hr 315 C 1 Sodium lactate ⁄6 M AB AB 160 mEq Physically compatible 3 C 1 Sodium lactate ⁄6 M BA LI 80 mEq Physically compatible for 24 hr 315 C Additive Compatibility Potassium chloride Test Drug Mfr Conc/L or % Mfr Conc/L or % Test Solution Remarks Ref C/I Amikacin sulfate BR 5 g LI 3 g D5LR, D5R, Physically compatible and both stable 294 C D5S, D5W, for 24 hr at 25°C D10W, LR, NS, R, SL Aminophylline 250 mg AB 3 g D5W Physically compatible 74 C Aminophylline SE 500 mg AB 40 mEq Physically compatible 6 C Amiodarone HCl LZ 1.8 g AB 40 mEq D5W, NSa Physically compatible. No amiodarone 1031 C loss in 24 hr at 24°C in light.