Potassium levels can be low as a result of a disease or from taking certain medicines, or after a prolonged illness with diarrhea or vomiting. Follow all directions on your prescription label and read all medication guides or instruction sheets.
Your doctor may occasionally change your dose. Use the medicine exactly as directed. Potassium chloride oral is taken by mouth.
Potassium chloride injection is given as a slow infusion into a vein. A healthcare provider will give you this medicine by injection if you have severely low potassium levels. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when potassium chloride is injected.
Do not crush, chew, or suck on a potassium tablet or capsule. Sucking on the pill could irritate your mouth or throat. Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device not a kitchen spoon.
Mix the oral solution with least 4 ounces of water before taking it. You may need to follow a special diet while using potassium chloride. Follow all instructions of your doctor or dietitian. Learn about the foods to eat or avoid to help control your condition. Call your doctor if you have trouble swallowing a potassium chloride capsule or tablet. You may be able to dissolve the tablet in water, or mix the medicine from a capsule with soft food.
Carefully follow your doctor's instructions. You may need frequent medical tests. Even if you have no symptoms, tests can help your doctor determine if this medicine is effective. Some tablets are made with a shell that is not absorbed or melted in the body. Part of this shell may appear in your stool. This study supports the common practice of administering 10 mEq of potassium for every 0.
Electrolytes, Clinical pharmacy, Adult medicine, Internal medicine, Evidence-based medicine. Hypokalemia is defined as a serum potassium concentration of less than 3. Hypokalemia is classified into stages of mild It takes a significant loss in potassium stores to see a drop in serum potassium level i. Severe consequences of hypokalemia include cardiac arrhythmias, rhabdomyolysis, and muscle weakness that leads to respiratory depression or ileus.
Chronic hypokalemia can cause increased ammoniagenesis, urinary concentration defects, polyuria, hypertension, acid base disorders, and hyperglycemia [ 3 , 6 ]. Potassium repletion is indicated when the total body stores of potassium are decreased and the degree of hypokalemia correlates with the magnitude of the deficiency in potassium [ 7 ]. The consideration to replete potassium via the oral or intravenous route depends on the ability of the patient to take oral medications and having a normal functioning gastrointestinal tract.
Patient specific variables such as renal function and body surface area have been proposed as being important in deciding to replete potassium [ 3 ]. There is a lack of evidence regarding the dose of potassium to administer in order to increase a serum potassium level by a certain amount [ 8 ].
Common practice has become to replete with 10 mEq of potassium for every 0. There exists a paucity of studies, and thereby, guidelines, to provide direction on how to most appropriately approach the repletion of potassium in the inpatient setting.
Most studies solely examine a critically ill patient population. A retrospective study by Kruse and Carlson from examined a medical intensive care unit population. The average increment of increase in serum potassium level per 20 mEq IV potassium infused was 0.
The serum potassium level was found to have increased an average of 0. This specific amount of time after infusion was not specified [ 10 ]. Patients in each of these studies had a mean baseline serum potassium level of 3. Most patients possessed adequate renal function. Recently, Chalwin and colleagues, in a study in critically ill patients, found that for every 20 mmol of IV potassium administered, there was a mean 0. The mean baseline potassium among the study population was 3. While these three studies overall roughly support the common practice of a 0.
Findings of this study showed a variable increase in serum potassium depending on the dose administered. The mean increase in serum potassium was 0. There was no difference in the increase in serum potassium level in patients with normal renal function as compared to those with renal insufficiency [ 12 ].
This study will aim to evaluate a diverse patient population receiving different doses of potassium. Variables such as the administration of IV versus PO potassium will be examined. Also, the impact of other patient specific factors such as the influence of concurrent medications, renal function and body mass index will be examined. This study was an institutional review board approved single-center, retrospective, medical record review.
Grady Health System is a licensed bed, urban, teaching hospital in Atlanta, Georgia with approximately 26, admissions per year. The purpose of this study is to quantify the change in serum potassium levels after potassium administration.
Patients included were chosen at random from a spreadsheet of people that received intravenous or oral potassium between January 1, and December 31, Patients were included if they had received the first dose of intravenous or oral potassium during the admission, if they had serum potassium level revealing hypokalemia within 4 hours before the potassium administration, and if they had labs obtained within 18 hours post conclusion of potassium administration.
The timeframe of 4 hours before and within 18 hours after administration of potassium was chosen to ensure the potassium level drawn was reflective of the true potassium level prior to and after potassium administration and monitoring is typical for inpatient practice.
For all patients for whom data was collected, no patients had more than one pre-potassium repletion serum potassium level obtained. If multiple post-potassium administration serum potassium levels were obtained, the latest of the levels was accounted for as it would be most reflective of the effect of potassium administration on serum potassium levels.
Patients were excluded if data regarding a potassium administration earlier in their admission was already included in the data. Patients were also excluded if they were still admitted at the time of data collection to maintain the retrospective nature of the study and received continuous scheduled potassium therapies. Continuous potassium therapies make it difficult to determine how much of the potassium administered affects a subsequently drawn serum potassium level.
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Planning by Care Setting. Planning by Specialty. In the event of bradycardia or tachycardia, call the doctor immediately and measure the blood pressure. If the potassium causes pain at the infusion site, check that the catheter is functional and slow down the infusion rate risk of necrosis if the fluid infiltrates outside the vein. Check the patient is drinking sufficient ORS. The same dose can be repeated once during the same day if necessary, by medical prescription, under medical supervision and only after a clinical examination.
It must always be diluted in infusion fluid RL or 0.
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