potassium gluconate

potassium gluconate

Potassium-Rougier (CA)

Pharmacologic class: Mineral, electrolyte

Therapeutic class: Electrolyte replacement, nutritional supplement

Pregnancy risk category C

Action

Maintains acid-base balance, isotonicity, and electrophysiologic balance throughout body tissues; crucial to nerve impulse transmission and contraction of cardiac, skeletal, and smooth muscle. Also essential for normal renal function and carbohydrate metabolism.

Availability

Elixir: 20 mEq/15 ml

Tablets: 2 mEq, 5 mEq

⊘Indications and dosages

➣ To prevent potassium depletion

Adults: Dosage highly individualized. Usual daily dosage is 20 mEq P.O. in divided doses.

➣ To treat potassium depletion

Adults: 40 to 100 mEq/day P.O. in divided doses, not to exceed 20 mEq in a single dose

Contraindications

• Hypersensitivity to tartrazine or alcohol (with some products)
• Acute dehydration
• Heat cramps
• Hyperkalemia
• Hyperkalemic familial periodic paralysis
• Severe renal impairment
• Severe hemolytic reactions
• Severe tissue trauma
• Untreated Addison's disease
• Concurrent use of potassium-sparing diuretics, angiotensin-converting enzyme (ACE) inhibitors, or salt substitutes containing potassium

Precautions

Use cautiously in:
• cardiac disease, renal impairment, diabetes mellitus, hypomagnesemia
• pregnant or breastfeeding patients
• children (safety and efficacy not established).

Administration

• Make sure patient is adequately hydrated and urinating before starting therapy.
• Give with food or meals and a full glass of water or juice to minimize GI upset.
• Be aware that potassium preparations are not interchangeable.
• Know that dosages are expressed in mEq of potassium and that potassium gluconate contains 4.3 mEq/g.

Route	Onset	Peak	Duration
P.O.	Unknown	1-2 hr	Unknown

Adverse reactions

CNS: confusion, unusual tiredness, restlessness, asthenia, flaccid paralysis, paresthesia

CV: ECG changes, hypotension, arrhythmias, heart block, cardiac arrest

GI: nausea, vomiting, diarrhea, abdominal discomfort, flatulence

Metabolic: hyperkalemia

Musculoskeletal: weakness and heaviness of legs

Interactions

Drug-drug. ACE inhibitors, potassium-sparing diuretics, other potassium preparations: increased risk of hyperkalemia

Drug-diagnostic tests. Potassium: increased level

Drug-food. Salt substitutes containing potassium: increased risk of hyperkalemia

Drug-herbs. Dandelion: increased risk of hyperkalemia

Licorice: decreased response to potassium

Patient monitoring

• Monitor renal function, fluid intake and output, and potassium, creatinine, and blood urea nitrogen levels.
☞ Know that potassium is contraindicated in patients with severe renal impairment and must be used with extreme caution (if at all) in patients with any degree of renal impairment, because of risk of life-threatening hyperkalemia.
• Monitor vital signs and check ECG for arrhythmias.
• Monitor patient's neurologic status for signs or symptoms of complications.

Patient teaching

• Tell patient to take oral form with or just after meals, with a glass of water or fruit juice.
• Instruct patient to dilute liquid form in water or juice and to sip it over 5 to 10 minutes.
• Advise patient to report nausea, vomiting, confusion, numbness and tingling, unusual tiredness or weakness, or a heavy feeling in legs.
• Tell patient to minimize GI upset by eating small, frequent servings of food and drinking plenty of fluids.
• Advise patient not to use salt substitutes.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, and herbs mentioned above.