Potassium chloride with glucose

How it works

The potassium chloride corrects or prevents hypokalaemia, while glucose provides fluid and energy and promotes intracellular potassium uptake when insulin is present.

Prescribing in practice

• Concentrated potassium must never be given as a rapid bolus; only suitably diluted, pre-mixed solutions should be infused at a controlled rate to avoid fatal hyperkalaemia and cardiac arrest.
• Use with caution in renal impairment and in patients on potassium-sparing diuretics, ACE inhibitors or other drugs that raise serum potassium.
• The glucose load can transiently lower serum potassium by driving it intracellularly and may cause hyperglycaemia, so monitor accordingly.

Monitoring

Monitor serum potassium, blood glucose and ECG during potassium-containing infusions, particularly in renal impairment or rapid replacement.

Counselling the patient

• Explain this drip replaces potassium and provides sugar and fluid.
• Report any palpitations, weakness or discomfort at the infusion site.

Evidence & guidelines

Ready-mixed potassium infusions are recommended over local addition of potassium to bags to reduce the risk of administration errors and inadvertent concentrated potassium dosing.