Pharmacodynamics and pharmacokinetics
According to Wikipedia, a solution of potassium chloride is intended to restore water and electrolyte balance . In moderate doses, the drug has a negative bathmotropic and chronotropic effect, in higher dosages it is characterized by negative dromotropic and inotropic effectiveness, and also exhibits a moderately pronounced diuretic (diuretic) effect.
The introduction of small doses of potassium helps to dilate the coronary vessels , and the use of large dosages narrows . The use of potassium preparations enhances the transmission of nerve intercellular impulses , and in the case of intravenous administration, it helps to increase the secretion of adrenaline .
The drug activates a large number of cytoplasmic enzymes , corrects osmotic intracellular pressure, protein replication , skeletal muscle contractility and amino acid transport. Reduces conductivity , heart rate , contractile activity, excitability and automatism of the myocardium . Increasing the content of this microelement in the body reduces the possibility of toxic effects of cardiac glycosides .
Indications for use
The use of Potassium Chloride is indicated for:
- hypokalemia (including patients with diabetes mellitus , vomiting , prolonged diarrhea , as well as patients using glucocorticoids , some diuretics and antihypertensive drugs);
- prevention and treatment of paroxysmal tachycardia , glycoside intoxication , ectopic arrhythmias (in the acute period of myocardial infarction ).
Pharmacokinetics
Suction
Since the drug is administered intravenously, its bioavailability is 100%.
Distribution
Potassium and chlorine ions are included in the general pool of the body. Potassium concentration and the acid-base state of blood plasma are closely related. Alkalosis is often accompanied by hypokalemia, and acidosis is often accompanied by hyperkalemia. Plasma potassium concentrations within the normal range during acidosis indicate potassium deficiency. The intracellular potassium concentration is about 140-150 mmol/l. The potassium concentration in the blood plasma is within the normal range from 3.5 to 5 mmol/l.
Biotransformation
Not applicable.
Removal
Potassium is mainly excreted by the kidneys with urine (about 90%), about 10% is excreted from the body through the gastrointestinal tract. Even in conditions of potassium deficiency, 10-50 mmol of potassium per day is excreted by the kidneys.
Contraindications
- atrioventricular block (complete);
- hyperkalemia;
- adrenal insufficiency;
- parallel use of potassium-sparing diuretics;
- age under 18 years;
- chronic kidney failure;
- metabolic disorders ( hyponatremia with hypovolemia , acidosis ).
Side effects
- muscle weakness;
- arrhythmias;
- paresthesia;
- allergic manifestations;
- confusion;
- decreased blood pressure;
- heart block;
- hyperkalemia;
- heart failure.
Instructions for use of Potassium Chloride
If indications for use of the drug are diagnosed, Potassium Chloride is prescribed intravenously in a bolus, using potassium chloride in ampoules, or infusion (drip) together with dextrose (5% solution).
In case of intoxication with glycosides, it is recommended to administer potassium chloride in a daily dosage of 2-3 grams, in case of serious intoxication - up to 5 grams.
For hypokalemia occurring with heart rhythm disturbances , 1-1.5 grams are prescribed 4-5 times every 24 hours, with a reduction in dosage after the heart rhythm is .
In case of continuous vomiting or manifestations of severe intoxication that require immediate elimination, use a 4% solution diluted in 40% glucose . 50 ml of the drug is dissolved in a tenfold higher dose (500 ml) of water daily and administered as an infusion with a frequency of 20-30 drops/min. It is also possible to administer by infusion at the rate of 2.5 grams in 500 ml of 5% dextrose or 0.9% sodium chloride .
To level out paroxysmal tachycardia, 8-12 grams of the drug are used on the first day, with a further reduction in the dosage to 3-6 grams.
In order to prevent or treat ectopic arrhythmias in the acute period of myocardial infarction , a polarizing mixture is prepared, for which potassium chloride is dissolved in 5-10% dextrose with the addition of short-acting insulin dextrose ).
pharmachologic effect
Mechanism of action
Potassium is the most important cation in the intracellular space; about 98% of the total potassium content in the body is found in the intracellular fluid. Potassium is involved in the electrochemical processes of the cell, as well as in carbohydrate and protein metabolism. During the synthesis of glycogen and proteins, potassium is consumed by cells, and during the breakdown of these substrates, potassium is released (about 0.4-1 mmol potassium/g glycogen and about 2-3 mmol potassium/g excreted nitrogen).
Therapeutic effect
The therapeutic effect of potassium chloride solutions for intravenous administration is the prevention or treatment of potassium deficiency when oral (or enteral) administration is impossible or insufficient. The daily requirement for potassium is about 1-1.5 mmol/kg body weight. Potassium deficiency may be caused by increased renal excretion, increased gastrointestinal losses, such as through vomiting, diarrhea, or fistulas, increased intracellular uptake, such as during treatment of acidosis or administration of dextrose and insulin, and insufficient potassium intake. Hypokalemia is accompanied by muscle weakness, gastrointestinal smooth muscle atony (ranging from constipation to intestinal obstruction), loss of the kidneys' ability to concentrate urine, electrocardiogram (ECG) changes, and cardiac arrhythmia.
Overdose
In case of overdose hyperkalemia , characterized by the following symptoms: muscle hypotonicity , paresthesia of the extremities, arrhythmia , inhibition of atrioventricular conduction, cardiac arrest . The first manifestations of hyperkalemia usually occur when the serum potassium is more than 6 mEq/L (loss of the U wave, if it was present on previous cardiograms; highlighting of the T wave; prolongation of the QT interval; decrease in the ST segment; increase in the QRS complex. Serious symptoms of hyperkalemia ( muscle paralysis and cardiac arrest ) are formed at a plasma content of 9-10 meq/l.
To relieve this condition, intravenous administration of 0.9% sodium chloride and 300-500 ml of 5% dextrose containing insulin (10-20 units/liter) is prescribed. If necessary, peritoneal dialysis and hemodialysis .
Potassium chloride
Registration certificate holder: GROTEX, LLC (Russia) ATX code: B05XA01 (Potassium chloride) Active substance: potassium chloride (potassium chloride) Ph.Eur. European Pharmacopoeia
Dosage form
Potassium chloride
Conc. d/prep. r-ra d/inf. 40 mg/1 ml: 10 ml amp. 10 pcs., 100 ml or 200 ml bottle. 1 piece reg. No.: LP-003059 dated 06/25/15 - Valid
Release form, packaging and composition
Concentrate for the preparation of a solution for infusion in the form of a clear, colorless or slightly yellowish liquid.
1 ml
potassium chloride 40 mg
Excipients: dextrose monohydrate - 334 mg, hydrochloric acid 1M solution - up to pH 3.0-4.0, water for injection - up to 1 ml.
10 ml - ampoules (10) - cardboard packs. 100 ml - polypropylene bottles (1) - cardboard packs. 200 ml - polypropylene bottles (1) - cardboard packs.
Clinical-pharmacological group: A drug that replenishes potassium deficiency in the body Pharmaco-therapeutic group: Potassium drug
pharmachologic effect
A remedy that replenishes potassium deficiency in the body. Helps maintain the necessary intra- and extracellular potassium levels. Potassium is the main intracellular ion and plays an important role in the regulation of various body functions. Participates in maintaining intracellular osmotic pressure, in the processes of conducting and transmitting nerve impulses to innervated organs, in the contraction of skeletal muscles and in a number of biochemical processes. Reduces the excitability and conductivity of the myocardium, in high doses it inhibits automatism.
Pharmacokinetics After oral administration, it is easily and in almost any quantity passively absorbed (70%), because its concentration (both food and released from the dosage form) is higher in the lumen of the small intestine than in the blood. In the ileum and colon, potassium is released into the intestinal lumen according to the principle of coupled exchange with sodium and is excreted with bile (10%). T1/2 in the absorption phase is 1.31 hours.
Indications for the drug Hypokalemia of various origins, incl. caused by vomiting, diarrhea, hyperaldosteronism, polyuria in chronic renal failure, taking certain medications, arrhythmias, incl. with glycoside intoxication, hypokalemic form of paroxysmal myoplegia. ICD-10 codes
Dosage regimen The method of administration and dosage regimen of a particular drug depend on its release form and other factors. The optimal dosage regimen is determined by the doctor. The compliance of the dosage form of a particular drug with the indications for use and dosage regimen should be strictly observed.
The daily dose for oral administration corresponds to 50-100 mEq of potassium, a single dose - 25-50 mEq of potassium, the frequency of administration and duration of use depend on the indications.
For intravenous administration, the dose and treatment regimen are determined individually.
Side effect
Possible symptoms of hyperkalemia: paresthesia in the upper and lower extremities, muscle weakness, arrhythmias, heart block, cardiac arrest, confusion.
After oral administration: nausea, vomiting, diarrhea, there are reports of ulcerative lesions of the stomach and small intestine, sometimes with bleeding, perforation, and subsequent formation of strictures.
After intravenous administration, hyperkalemia may manifest itself primarily by the development of cardiac dysfunction.
Contraindications for use Impaired renal excretory function, complete heart block, hyperkalemia of various etiologies, metabolic disorders (acidosis, hypovolemia with hyponatremia), gastrointestinal diseases in the acute phase, adrenal insufficiency.
Use during pregnancy and breastfeeding If use during pregnancy is necessary, the expected benefits for the mother should be weighed against the potential risk to the fetus; during lactation, the issue of stopping breastfeeding should be decided.
Use for renal impairment
Contraindicated in cases of impaired renal excretory function.
Patients with chronic kidney disease may develop hyperkalemia, which can potentially be fatal. Early clinical manifestations of hyperkalemia (sharpening of the P wave, disappearance of the U wave, lowering of the ST segment, and prolongation of the QT interval) usually appear at serum potassium concentrations of 7 to 8 mEq/L.
special instructions
Use with caution for AV conduction disorders, orally for gastrointestinal diseases. During treatment, it is necessary to monitor the level of potassium in the blood and ECG, and when treating potassium-deficient conditions, ASC should be carefully monitored.
Patients with chronic kidney disease or any disease that impairs the excretion of potassium from the body, or if potassium chloride is administered too quickly intravenously, may develop hyperkalemia, which can potentially be fatal. Early clinical manifestations of hyperkalemia (sharpening of the P wave, disappearance of the U wave, lowering of the ST segment, and prolongation of the QT interval) usually appear at serum potassium concentrations of 7 to 8 mEq/L. More severe symptoms (including muscle paralysis and cardiac arrest) develop at potassium concentrations of 9-10 mEq/L. It should be borne in mind that hyperkalemia, which can be fatal, can develop quickly and be asymptomatic. In case of an overdose of potassium chloride, a sodium chloride solution is administered orally or intravenously, or intravenously 300-500 ml of dextrose solution containing 10-20 units of insulin per 1000 ml. If necessary, hemodialysis and peritoneal dialysis are performed.
The safety and effectiveness of potassium chloride in children have not been established.
Drug interactions When used simultaneously, potassium-sparing diuretics, potassium supplements, ACE inhibitors, and salt substitutes containing potassium increase the risk of developing hyperkalemia.
Interaction
Increases the negative bathmotropic and dromotropic effectiveness of antiarrhythmic drugs .
When used in parallel with cardiac glycosides, it improves their tolerability.
The combined use of Cyclosporine , Heparin , beta-blockers, potassium-sparing diuretics, ACE inhibitors, NSAIDs may increase the possibility of hyperkalemia .
special instructions
It should be borne in mind that foods containing large amounts of sodium potassium from the body .
Throughout the use of the drug, it is necessary to monitor the serum content of potassium ions and conduct an electrocardiogram .
When treating symptoms of hypokalemia, the acid-base should be monitored .
It must be remembered that severe hyperkalemia , which can cause death, develops asymptomatically and quite quickly.
The use of potassium chloride as a fertilizer
In addition to the use of potassium chloride in medicine, it is widely used in industry (production of leather substitutes, rubber, etc.), as well as in agriculture as a fertilizer. GOST 4568 95 (state standard) regulates all provisions on production, appearance, packaging, sanitary requirements, methods and methods of use, etc. namely technical and agricultural potassium .
The use of potassium chloride in gardening and gardening, in addition to saturating the soil, has a number of positive aspects for the plants themselves, such as: increased yield, increased resistance to frost, disease, drought, pests, increased shelf life and appearance of fruits and tubers, reduced content they contain nitrates and radionuclides . The main sphere of influence is perennial fruit and berry plants, vegetable crops and ornamental plantings.
Potassium and magnesium aspartate
The drug is included in the list of vital and essential drugs (VED).
The drug produced by LLC "IST-PHARM" and LLC "Pharmasyntez-Tyumen" under the name "Potassium and Magnesium asparaginate" contains the following components: potassium and magnesium, respectively.
The human body contains almost all the chemical elements of the periodic table (injection solution “Glucose”). However, some trace elements are present in significantly higher quantities and their role is well studied. With potassium deficiency, hypokalemia develops (laboratory determination of the microelement Potassium is mandatory in ICU conditions according to indications). Hypokalemia is accompanied by the following, often life-threatening, symptoms: heart rhythm disturbances; frequent cramps, pain; irritability; tremor of hands, feet; coordination problems; muscle weakness, constant drowsiness; fast fatiguability. The role of potassium ions is to maintain osmotic pressure and cell volume, acid-base balance, and regulate enzyme activity. The concentration of potassium inside cells exceeds its extracellular level by 20-40 times. Potassium ions affect cardiac conductivity (the ability of the heart to transmit a signal about the need to contract the heart muscle) and regulate heart function, increase the tone and strength of smooth and striated muscles, and take part in the activity of the nervous system.
Magnesium, along with calcium, sodium and potassium, is one of the first four minerals in the body, and in terms of content inside the cell it ranks second after potassium. Magnesium is especially actively involved in processes that are associated with energy utilization, in particular, with the breakdown of glucose and the removal of waste waste and toxins from the body (see “Glucose 5%” infusion solution for more details). It has been confirmed that the vitamins thiamine (B1), pyridoxine (B6) and vitamin C (necessary for the full functioning of the body, for example, a lack of Vitamin C leads to scurvy) are fully absorbed in the presence of such a microelement as Magnesium. It is thanks to Magnesium that during the process of cell growth, their structure becomes more stable, regeneration (the ability of living organisms to restore damaged tissue over time) and cell renewal of tissues and organs is more effective. Magnesium stabilizes the bone structure and gives bones strength.
The drug "Potassium and Magnesium aspartate" is used as prescribed by a doctor based on the results of studies of trace elements in blood serum and the specific clinical situation.
Analogs
Level 4 ATC code matches:
Calcium Chloride
Calcium chloride
Magnesium sulfate
Sodium chloride
Rheosorbilact
Reamberin
Analogs of the drug, according to the ATX code up to the fourth digit, are solutions: Calcium Chloride and Sodium Chloride , Xylate , Glyxil , Magnesium Sulfate , Laktoxyl , Soda-Buffer , Reamberin , etc.
Price of Potassium Chloride, where to buy
In Russian pharmacies you can buy Potassium Chloride 30 mg/ml: 100 ml – 40-45 rubles; 200 ml – 50-55 rubles.
You can buy Potassium Chloride 150 mg/ml: 100 ml – 45-50 rubles; 200 ml – 55-65 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Potassium chloride bufus conc.
ready r-ra d/inf. 40mg/ml amp. 10ml No. 10AO Update PFK 123 RUR order
Pharmacy Dialogue
- Potassium chloride (amp. 4% 10ml No. 10)Grotex LLC
92 rub. order
- Potassium chloride (amp. 4% 10ml No. 10)Update of PFC JSC
132 RUR order
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Pharmacy24
- Potassium chloride 7.5% 10 ml solution TOV "Yuriya-Pharm", Ukraine
22 UAH. order - Potassium chloride 7.5% 20 ml TOV Yuria-Pharm, Ukraine
40 UAH order
- Potassium chloride 4% 50 ml solution ZAT"Infusion", Ukraine
25 UAH order
PaniPharmacy
- Potassium chloride infusion Potassium chloride solution for inf. 4% 50 ml Ukraine, Infusion JSC
21 UAH order
- Potassium chloride infusion Potassium chloride conc. d/r-ra d/inf.7.5% 10ml Ukraine, Yuria-Pharm LLC
22 UAH order
- Potassium chloride infusion Potassium chloride conc. d/r-ra d/inf.7.5% 20ml Ukraine, Yuria-Pharm LLC
34 UAH order
- Potassium chloride infusion Potassium chloride solution for inf. 4% 100ml Ukraine, Infusion JSC
36 UAH order
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Directions for use and doses
The drug is administered intravenously by drip only after diluting the concentrate to obtain an isotonic solution (potassium chloride concentration will be 4 mg/ml or 0.4%) and administered intravenously by drip (at a rate of 20-30 drops per minute). At the same time, no more than 100 ml of the prepared solution is administered in one infusion. If necessary, the infusion can be repeated, but the total daily dose should not exceed 300-500 ml of the prepared solution with a potassium chloride concentration of 4 mg/ml (0.4%).
For intravenous drip administration, you can prepare a solution of up to 2.5 g of potassium chloride in 500 ml of isotonic 0.9% sodium chloride solution or 5% dextrose (glucose) solution. For the prevention and treatment of ectopic arrhythmias during myocardial infarction, a polarizing mixture is used: a solution of potassium chloride 2-2.5 g in 500 ml of 5-10% dextrose (glucose), to which short-acting insulin is added at the rate of 1 unit per 3-4 g dry dextrose (glucose).
Doses
The dose for the treatment of potassium deficiency should be selected in accordance with the actual concentration of electrolytes in the blood plasma and acid-base status.
1 mmol of potassium (K+) corresponds to 75 mg of potassium chloride (KCl).
Adults and elderly patients
Dosage for the treatment of moderate, asymptomatic potassium deficiency and for maintenance therapy:
The amount of potassium required to correct moderate potassium deficiency and during maintenance therapy can be calculated using the following formula:
required amount of mmol K+ = (MW* [kg] x 0.2)** x 2 x (target
concentration of K+ in blood plasma *** - actual concentration of K+ in
blood plasma [mmol/l])
Where:
*BW = body weight;
**value represents extracellular fluid volume;
***the target plasma K+ concentration should be 4.5 mmol potassium/l.
Maximum daily dose (for example, in case of severe symptomatic hypokalemia or significant losses): up to 2-3 mmol potassium/kg body weight.
Maximum rate of administration: up to 20 mmol potassium/hour in adults (corresponding to 0.3 mmol potassium/kg body weight/hour). If the plasma potassium concentration is less than 2 mmol potassium/l, the infusion rate can reach 40 mmol potassium/hour.
Patients with diabetes mellitus
Changes in the acid-base state affect the concentration of potassium in the blood plasma. The need for potassium increases when compensating for ketoacidosis in patients with diabetes mellitus, as well as when administering dextrose/short-acting insulin.
If possible, oral potassium supplements should be prescribed.
