Potassium chloride (medical use)

Potassium chloride
Names
Trade namesKay-Cee-L, Slow-K, others
Clinical data
Pregnancy
category
  • US: C (Risk not ruled out)
    Routes of
    use    		By mouth
    Defined daily dose3 grams[1]
    External links
    AHFS/Drugs.comMultum Consumer Information
    Legal
    License data
    Chemical and physical data
    FormulaKCl
    Molar mass74.5513
    3D model (JSmol)
    SMILES
    • [Cl-].[K+]
    InChI
    • InChI=1S/ClH.K/h1H;/q;+1/p-1
    • Key:WCUXLLCKKVVCTQ-UHFFFAOYSA-M

    Potassium chloride, also known as potassium salt, is used as a medication to treat and prevent low blood potassium.[2] Low blood potassium may occur due to vomiting, diarrhea, or certain medications.[3] The concentrated version should be diluted before use.[2] It is given by slow injection into a vein or by mouth.[4]

    Side effects may include heart problems if given too quickly by injection into a vein.[4] By mouth it can result in abdominal pain, peptic ulcer disease, or gastrointestinal bleeding.[4] Greater care is recommended in those with kidney problems.[2] As long as high blood potassium does not occur, use in pregnancy or breastfeeding is believed to be safe for the baby.[5] Generally, the strength of the formulation for injection into a vein should not be greater than 40 mmol/l (3 mg/l).[4]

    Potassium chloride came into large scale commercial use as a fertilizer in 1861 and has been used medically since the 1950s.[6][7] It is on the World Health Organization's List of Essential Medicines.[8] Potassium chloride is available as a generic medication.[4] The wholesale cost in the developing world is about 0.44 USD per 10 ml of 10% solution.[9] In the United Kingdom 10 ml of 15% solution costs the NHS about 0.48 pounds.[4] In 2017, it was the 37th most commonly prescribed medication in the United States, with more than 19 million prescriptions.[10][11]

    Medical use

    Potassium chloride is used in the treatment of hypokalemia as an electrolyte replenisher.[12] With a molecular weight of approximately 75 and a valence of 1, the use of KCl for electrolytes makes 75 mg the equivalent of 1 mEq.

    Some cardiac surgery procedures cannot be carried out on the beating heart. For these procedures, the surgical team will bypass the heart with a heart-lung machine and inject potassium chloride into the heart muscle to stop the heartbeat.

    Dosage

    The defined daily dose is 3 grams by mouth.[1] In those who weight more than 45 kg this can be given as 30 mmol (30 ml) of 7.5% solution of KCL (1 mmol per ml) three times per day.[13] It is also available as 600 mg (8 mmol) of which two to three per day may be given in adults.[14] In children the dose is 2 mmol/kg (2 ml/kg) given in two to three doses during the day.[13] In adults the intravenous formulation may be given at a rate of 10 mmol/hour while in children the dose is 0.2 mmol/kg/hour.[15]

    Side effects

    Side effects can include gastrointestinal discomfort, including nausea and vomiting, diarrhea, and bleeding of the digestive tract.

    Overdoses cause hyperkalemia, which can lead to paresthesia, cardiac conduction blocks, fibrillation, arrhythmias, and sclerosis.[16] Because of the danger of hyperkalemia, the US FDA limits the amount of potassium supplements to 99 mg (about 1.3 mEq) while recommending an adult daily intake of 4700 mg (about 63 mEq).

    History

    Slow-K is a 1950s development where the medicine is formulated to enter the bloodstream at delayed intervals. It was first only prescribed to British military forces to balance their diets while serving in Korea.[17]

    Society

    Cost

    The wholesale cost in the developing world is about 0.44 USD per 10 ml of 10% solution.[9] In the United Kingdom 10 ml of 15% solution costs the NHS about 0.48 pounds.[4] In 2017, it was the 37th most commonly prescribed medication in the United States, with more than 19 million prescriptions.[10][11]

    • Potassium costs (US)
      Potassium costs (US)
    • Potassium prescriptions (US)
      Potassium prescriptions (US)

    Brand names

    Brand names include K-Dur, Klor-Con, Micro-K, Slow-K, Sando-K and Kaon Cl, most of which are extended release medicine by mouth.

    Lethal injection

    Potassium chloride is used in lethal injection as the third of a three-drug combination. KCl is also sometimes used in fetal intracardiac injections in second- and third-trimester induced abortions.[18][19] Jack Kevorkian's thanatron machine injected a lethal dose of potassium chloride into the patient, which caused the heart to stop functioning, after a sodium thiopental-induced coma was achieved.[20]

    Cardiac arrest induced by potassium has been used in political assassinations in Iran, by injection or by inserting a potassium suppository into the victim's rectum.[21]

    References

    1. 1 2 "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 7 August 2020. Retrieved 4 September 2020.
    2. 1 2 3 World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. p. 491. hdl:10665/44053. ISBN 9789241547659.
    3. ↑ "Potassium chloride medical facts from Drugs.com". www.drugs.com. Archived from the original on 18 January 2017. Retrieved 14 January 2017.
    4. 1 2 3 4 5 6 7 British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. pp. 680, 684. ISBN 9780857111562.
    5. ↑ "Klor-Con M - FDA prescribing information, side effects and uses". www.drugs.com. Archived from the original on 18 January 2017. Retrieved 14 January 2017.
    6. ↑ Velde, Pierre; Barré, Pierre (2009). Soils, Plants and Clay Minerals: Mineral and Biologic Interactions. Springer Science & Business Media. p. 275. ISBN 9783642034992. Archived from the original on 18 September 2017.
    7. ↑ BNA's Patent, Trademark & Copyright Journal. Bureau of National Affairs, Incorporated. 1991. Archived from the original on 18 September 2017. Potassium chloride, used since the 1950s for the treatment of potassium depletion in humans
    8. ↑ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
    9. 1 2 "Potassium Chloride". International Drug Price Indicator Guide. Archived from the original on 22 January 2018. Retrieved 8 December 2016.
    10. 1 2 "The Top 300 of 2020". ClinCalc. Archived from the original on 18 March 2020. Retrieved 11 April 2020.
    11. 1 2 "Potassium Drug Usage Statistics". ClinCalc. 23 December 2019. Archived from the original on 12 April 2020. Retrieved 11 April 2020.
    12. ↑ Hypokalemia in Emergency Medicine~treatment at eMedicine
    13. 1 2 "POTASSIUM CHLORIDE immediate-release oral - Essential drugs". medicalguidelines.msf.org. Archived from the original on 28 August 2021. Retrieved 23 August 2020.
    14. ↑ "POTASSIUM CHLORIDE sustained-release oral - Essential drugs". medicalguidelines.msf.org. Archived from the original on 28 August 2021. Retrieved 23 August 2020.
    15. ↑ "POTASSIUM CHLORIDE 10% = KCl 10% injectable - Essential drugs". medicalguidelines.msf.org. Archived from the original on 12 November 2020. Retrieved 4 September 2020.
    16. ↑ Hyperkalemia in Emergency Medicine at eMedicine
    17. ↑ He, F. J.; Markandu, N. D.; Coltart, R.; Barron, J.; MacGregor, G. A. (2005). "Effect of Short-Term Supplementation of Potassium Chloride and Potassium Citrate on Blood Pressure in Hypertensives". Hypertension. 45 (4): 571–4. doi:10.1161/01.HYP.0000158264.36590.19. PMID 15723964.
    18. ↑ Stubblefield, Phillip G.; Carr-Ellis, Sacheen; Borgatta, Lynn (2004). "Methods for Induced Abortion". Obstetrics & Gynecology. 104 (1): 174–85. doi:10.1097/01.AOG.0000130842.21897.53. PMID 15229018.
    19. ↑ Types of Abortion Procedures Archived 2009-04-18 at the Wayback Machine. Americanpregnancy.org (2011-09-20). Retrieved on 2012-02-16.
    20. ↑ Boyes, Roger (29 March 2008). "Death for hire – suicide machine lets you push final button". The Times. Archived from the original on 3 September 2016. Retrieved 14 January 2017.
    21. ↑ Sahimi, Muhammad. "The Chain Murders: Killing Dissidents and Intellectuals, 1988-1998". pbs.org. FRONTLINE. Archived from the original on 11 December 2016. Retrieved 27 November 2016.
    • "Potassium chloride". Drug Information Portal. U.S. National Library of Medicine. Archived from the original on 17 December 2019. Retrieved 17 December 2019.
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