Mosby's 2014 Nursing Drug Reference (324 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
OTC
, Rx)
K Effervescent, Klor-Con EF, K-Vescent
OTC
, Rx)
Neo-K
OTC
, Rx)
OTC
, Rx)
Epiklor, Klor-Con, K-Tab, Micro-K, Odan K-20
OTC
, Rx)
Equaline Potassium Gluconate, Walgreens Finest Natural Potassium Gluconate
Func. class.:
Electrolyte, mineral replacement
Chem. class.:
Potassium
Needed for the adequate transmission of nerve impulses and cardiac contraction, renal function, intracellular ion maintenance
Prevention and treatment of hypokalemia
Renal disease (severe), severe hemolytic disease, Addison’s disease, hyperkalemia, acute dehydration, extensive tissue breakdown
Precautions:
Pregnancy (C), cardiac disease, potassium-sparing diuretic therapy, systemic acidosis
Calculator
• Adult:
PO
20 mEq/day in 1-2 divided doses
• Child:
PO
1-2 mEq/kg/day in 1-2 divided doses
• Adult:
serum potassium conc >2.5 mEq/L:
IV
max 10 mEq/1 hr with 24-hr max dose 200 mEq, initial dose of 20-40 mEq has been recommended;
PO
40-100 mEq/day in 2-4 divided doses
• Child:
IV
0.25-0.5 mEq/kg/dose at 0.25-0.5 mEq/kg/hr;
PO
2-5 mEq/day in divided doses
Available forms:
Tabs for sol 6.5, 25 mEq; ext rel caps 8, 10 mEq; powder for sol 3.3, 5, 6.7, 10, 13.3 mEq/5 ml; tabs 2, 4, 5, 13.4 mEq; ext rel tabs 6.7, 8, 10 mEq; elix 6.7 mEq/5 ml; oral sol 2.375 mEq/5 ml; inj for prep of IV 1.5, 2, 2.4, 3, 3.2, 4.4, 4.7 mEq/ml
•
Do not break, crush, or chew ext rel tabs, caps or enteric products
•
With or after meals; dissolve effervescent tabs, powder in 8 oz cold water or juice; do not give IM, SUBCUT
•
Caps with full glass of liquid
•
Through large-bore needle to decrease vein inflammation; check for extravasation; in large vein, avoid scalp vein in child (IV)
Additive compatibilities:
Metoclopramide
Y-site compatibilities:
Ciprofloxacin
•
Potassium chloride:
must be diluted; concentrated potassium injections fatal
•
Conc max 80 mcg/L for peripheral line, 120 mEq/L for central line
•
Dehydrated patients should receive 1 L of potassium-free hydrating solution then infuse 10 mEq/hr; in severe hypokalemia, rate may be 40 mEq/hr
Additive compatibilities:
Aminophylline, amiodarone, atracurium, calcium gluconate, cefepime, cephalothin, cephapirin, chloramphenicol, cimetidine, ciprofloxacin, cisatracurium, clindamycin, cloxacillin, corticotropin, cytarabine, dimenhyDRINATE, DOPamine, DOXOrubicin liposome, enalaprilat, erythromycin, floxacillin, fluconazole, fosphenytoin, furosemide, heparin, hydrocortisone, isoproterenol, lidocaine, metaraminol, methicillin, methyldopate, metoclopramide, mitoXANtrone, nafcillin, netilmicin, norepinephrine, oxacillin, penicillin G potassium, phenylephrine, piperacillin, ranitidine, sodium bicarbonate, thiopental, vancomycin, verapamil, vit B/C
Y-site compatibilities:
Acyclovir, aldesleukin, allopurinol, amifostine, aminophylline, amiodarone, ampicillin, amrinone, atropine, aztreonam, betamethasone, calcium gluconate, cephalothin, cephapirin, chlordiazePOXIDE, chlorproMAZINE, ciprofloxacin, cladribine, cyanocobalamin, dexamethasone, digoxin, diltiazem, diphenhydrAMINE, DOBUTamine, DOPamine, droperidol, edrophonium, enalaprilat, EPINEPHrine, esmolol, estrogens, ethacrynate, famotidine, fentaNYL, filgrastim, fludarabine, fluorouracil, furosemide, gallium, granisetron, heparin, hydrALAZINE, IDArubicin, indomethacin, insulin (regular), isoproterenol, kanamycin, labetalol, lidocaine, LORazepam, magnesium sulfate, melphalan, meperidine, methicillin, methoxamine, methylergonovine, midazolam, minocycline, morphine, neostigmine, norepinephrine, ondansetron, oxacillin, oxytocin, PACLitaxel, penicillin G potassium, pentazocine, phytonadione, piperacillin/tazobactam, prednisoLONE, procainamide, prochlorperazine, propofol, propranolol, pyridostigmine, remifentanil, sargramostim, scopolamine, sodium bicarbonate, succinylcholine, tacrolimus, teniposide, theophylline,
thiotepa, trimethaphan, trimethoenzamide, vinorelbine, warfarin, zidovudine
CNS:
Confusion
CV:
Bradycardia,
cardiac depression, dysrhythmias, arrest; peaking T waves, lowered R, depressed RST, prolonged P-R interval, widened QRS complex
GI:
Nausea, vomiting, cramps
, pain,
diarrhea
, ulceration of small bowel
GU:
Oliguria
INTEG:
Cold extremities, rash
PO:
Excreted by kidneys and in feces; onset of action ≈30 min
IV:
Immediate onset of action
Increase:
hyperkalemia—potassium phosphate IV; products containing calcium or magnesium; potassium-sparing diuretic or other potassium products; ACE inhibitors
•
Hyperkalemia:
indicates toxicity; fatigue, muscle weakness, confusion, dyspnea, palpitation; ECG for peaking T waves, lowered R, depressed RST, prolonged P-R interval, widening QRS complex, hyperkalemia; product should be reduced or discontinued, administer sodium bicarbonate (metabolic acidosis)
•
Potassium level during treatment (3.5-5 mg/dl is normal level)
•
Determine hydration status, I&O ratio; watch for decreased urinary output; notify prescriber immediately
•
Cardiac status: rate, rhythm, CVP, PWP, PAWP if being monitored directly
•
Storage at room temp
•
Therapeutic response: absence of fatigue, muscle weakness; decreased thirst, urinary output; cardiac changes
•
To add potassium-rich foods to diet: bananas, orange juice, avocados, whole grains, broccoli, carrots, prunes, cocoa after product is discontinued
•
To avoid OTC products: antacids, salt substitutes, analgesics, vitamin preparations unless specifically directed by prescriber; to avoid licorice in large amounts because it may cause hypokalemia, sodium retention
•
To report hyperkalemia symptoms (lethargy, confusion, diarrhea, nausea, vomiting, fainting, decreased output) or continued hypokalemia symptoms (fatigue, weakness, polyuria, polydipsia, cardiac changes)
•
To dissolve powder or tablet completely in ≥120 ml water or juice
•
About the importance of regular follow-up visits
•
That potassium levels will need to be monitored periodically
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert