Potassium Chloride / Potassium Gluconate

What it is used for

• Treatment of chronic mild hypokalemia (3.0-3.5 mEq/L)
• Treatment of chronic mild hypokalemia (Tumil-K powder)
• Moderate to severe (<3.0 mEq/L) or acute hypokalemia
• Subcutaneous fluid supplementation (<10 kg patients)
• Oral maintenance supplementation
• Sliding scale IV supplementation based on Serum K+
• Hypokalemia in 'downer' cows
• Hypokalemia maintenance/treatment
• Severe hypokalemia (<2.3 mEq/L) with severe muscle weakness or recumbency
• Counteract potassium depletion in a completely anorectic horse
• Hypokalemia with diarrhea
• Treatment of chronic mild hypokalemia (3.0-3.5 mEq/L)

How it is given

Possible side effects

• Hyperkalemia (muscle weakness, cardiac conduction disturbances)
• Gastrointestinal distress (vomiting, diarrhea) with oral therapy
• Vein irritation and phlebitis with IV therapy

Cautions & contraindications

• Hyperkalemia
• Renal failure or severe renal impairment
• Severe hemolytic reactions
• Untreated Addison's disease (hypoadrenocorticism)
• Acute dehydration
• GI motility impairment (for solid oral dosage forms)
• > **CRITICAL WARNING:** Intravenous potassium salts **MUST** be diluted before administering and given slowly. Rapid IV administration can cause fatal cardiac arrest. * **Maximum standard IV rate:** Generally should not exceed 0.5 mEq/kg/hour. In dire circumstances (<2.0 mEq/L), rates up to 1.5 mEq/kg/hour may be used **only** with continuous ECG monitoring. * Assess renal and cardiac function prior to therapy. * Acid-base balance masks the actual potassium picture: acidosis causes a false elevation (shifts K+ out of cells), while alkalosis causes a falsely low serum value. * Supplementation should generally occur over 3-5 days to allow equilibration between extracellular and intracellular fluids. * Use cautiously in digitalized patients.

Drug interactions

• ACE Inhibitors (e.g., enalapril): Potassium retention may occur; increased risk for hyperkalemia.
• Digoxin: In patients with severe or complete heart block receiving digitalis therapy, it is often recommended not to use potassium salts.
• NSAIDs: Oral potassium given with non-steroidal anti-inflammatory agents may increase the risk of gastrointestinal adverse effects.
• Potassium-Sparing Diuretics (e.g., spironolactone): Potassium retention may occur; increased risk for hyperkalemia.

Frequently asked questions