Potassium Bicarbonate + Potassium Chloride

Indications

Potassium Bicarbonate + Potassium Chloride is used for: Hypokalemia

Adult Dose

Adult Hypokalemia Oral: 40 to 100 mEq orally once a day given in equally divided doses using formulations which include normal-release tablets or capsules, extended-release tablets or capsules, dissolvable tablets, oral solution or powder for dissolution mixed with an appropriate volume of water or juice. Prevention of Hypokalemia. 10 to 20 mEq orally once a day given in equally divided doses using formulations which include normal-release tablets or capsules, extended-release tablets or capsules, dissolvable tablets, oral solution or powder for dissolution mixed with an appropriate volume of water or juice.

Child Dose

Infants and Children: Oral: 2 to 5 mEq/kg/day in divided doses; not to exceed 1 to 2 mEq/kg as a single dose; if deficits are severe or ongoing losses are great, IV route should be considered preferred route of administration. Normal daily requirements: Oral or IV: Infants: 2 to 6 mEq/kg/day Children: 2 to 3 mEq/kg/day Prevention of hypokalemia during diuretic therapy: Infants and Children: 1 to 2 mEq/kg/day orally in 1 to 2 divided doses

Renal Dose

Administration

Contra Indications

Hypersensitivity.

Precautions

Potassium chloride (KCl) is contraindicated in the presence of hyperkalemia; renal failure and conditions in which potassium retention is present, including the concomitant use of potassium-sparing diuretics (such as triamterene, amiloride, or spironolactone); oliguria or azotemia; anuria; crush syndrome; severe hemolytic reactions; adrenocortical insufficiency (untreated Addison's disease); adynamical episodica hereditaria; acute dehydration; heat cramps; and early postoperative oliguria except during gastrointestinal drainage. Patients should not use potassium-rich salt substitutes without the advice of their healthcare professional during KCl therapy. In patients with renal insufficiency, use of potassium chloride may cause potassium intoxication and life-threatening hyperkalemia. Solid oral dosage forms of potassium chloride can produce ulcerative and/or stenotic lesions of the gastrointestinal tract. Potassium chloride should be discontinued immediately and the possibility of ulceration, obstruction, or perforation should be considered if severe vomiting, abdominal pain, distention, or gastrointestinal bleeding occurs. Clinical evaluation and periodic laboratory evaluations are necessary to monitor changes in fluid balance, electrolyte concentrations, and acid-base balance during prolonged parenteral therapy or whenever the condition of the patient warrants such evaluation. Significant deviations from normal concentrations may require the administration of additional electrolyte supplements, or the administration of electrolyte-free dextrose solutions to which individualized electrolyte supplements may be added. Certain potassium chloride extended-release tablets contain a wax matrix. This matrix is not absorbed and is excreted in the feces. In some instances the empty matrices may be noticeable in the stool. Dose selection in the elderly should be cautious and should start at the lower end of the dosing range.

Pregnancy-Lactation

Interactions

Adverse Effects

Side effects of Potassium Bicarbonate + Potassium Chloride : Metabolic Metabolic side effects have been reported rarely and have usually resulted from hyperkalemia. The risk of hyperkalemia is relatively high in patients with preexisting renal insufficiency. Gastrointestinal Gastrointestinal (GI) side effects have been reported from orally administered potassium chloride. They have included bad taste or aftertaste, nausea (10% to 30%), abdominal pain (20%), diarrhea (25%), dyspepsia or "heartburn" (5% to 20%) and GI ulceration. They have rarely included gastric or small bowel obstruction associated with the use of solid preparations. All solid KCl preparations can cause erosive damage to the GI mucosa, especially when they are administered in high doses with an anticholinergic agent. Anticholinergic agents increase GI transit (and potassium-mucosa contact) time. Patients at higher risk of GI lesions include the elderly, the immobile and those with scleroderma, diabetes mellitus, mitral valve replacement, cardiomegaly or esophageal stricture. Nearly half of all patients complain of a bad taste or aftertaste. Liquid KCl may be a better choice for patients with a history of esophageal stenosis or left atrial enlargement. Hypersensitivity Hypersensitivity side effects have been reported rarely. They have included a single case of contact dermatitis. Dermatologic Dermatologic side effects have rarely included skin rash.

Mechanism of Action

Potassium depletion occurs when rate of loss through renal excretion and/or GI tract exceeds intake. Supplementation with potassium-containing products may alleviate depletion. Potassium plays essential role in the conduction of nerve impulses in the heart, brain, and skeletal muscle; plays a role in contraction of cardiac, skeletal, and smooth muscles. Potassium chloride is a major cation of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and skeletal muscle; contraction of cardiac skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism and gastric secretion.