Potassium chloride (medical use)

For general information about medical use of potassium, see Potassium in biology.

Potassium chloride

Clinical data
Pronunciation	poe tass' i um klor' ide
Trade names	Kay-Cee-L, Slow-K, others
AHFS/Drugs.com	Professional Drug Facts
License data	US DailyMed: Potassium chloride
Routes of administration	By mouth, intravenous
ATC code	B05XA01 (WHO) A12BA01 (WHO), A12BA51 (WHO)
Legal status
Legal status	AU: S4 (Prescription only) US: WARNING[1]Rx-only
Identifiers
CAS Number	7447-40-7
PubChem CID	24015
DrugBank	DB00761
ChemSpider	4707
UNII	660YQ98I10
KEGG	D02060
ChEBI	CHEBI:32588
ChEMBL	ChEMBL1200731
Chemical and physical data
Formula	ClK
Molar mass	74.55 g·mol^−1
3D model (JSmol)	Interactive image
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] In 2022, it was the 35th most commonly prescribed medication in the United States, with more than 16 million prescriptions.[9][10]

Medical uses

Potassium chloride is used in the treatment of hypokalemia as an electrolyte replenisher.[11]

Potassium chloride contains 52% of elemental potassium by mass.[12]

Side effects

Side effects can include gastrointestinal discomfort, including nausea and vomiting, diarrhea, and bleeding of the digestive tract.^[medical citation needed]

Overdoses cause hyperkalemia, which can lead to paresthesia, cardiac conduction blocks, fibrillation, arrhythmias, and sclerosis.[13]

Because of the risk of small-bowel lesions, the US Food and Drug Administration (FDA) requires some potassium salts containing more than 99 mg (about 1.3 mEq) to be labeled with a warning,[14] 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.[15]

Society and culture

Brand names

Brand names include K-Dur, Klor-Con, Micro-K, Slow-K, Sando-K, and Kaon Cl.

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.[16][17] 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.[18]

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.[19]

References

1. "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 October 2023.
2. 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". Drugs.com. Archived from the original on 18 January 2017. Retrieved 14 January 2017.
4. 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". Drugs.com. Archived from the original on 18 January 2017. Retrieved 14 January 2017.
6. Velde P, Barré P (2009). "Man and Agriculture: Manipulating Soil – Plant Interactions". 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 (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
9. "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
10. "Potassium Chloride Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Archived from the original on 7 October 2024. Retrieved 30 August 2024.
11. Hypokalemia in Emergency Medicine~treatment at eMedicine
12. Zakiah K, Maulana MR, Widowati LR, Mutakin J (2021). "Applications of guano and K₂CO₃ on soil potential-P, potential-K on Andisols". IOP Conference Series: Earth and Environmental Science. 648: 012185. doi:10.1088/1755-1315/648/1/012185.
13. Hyperkalemia in Emergency Medicine at eMedicine
14. "Office of Dietary Supplements - Potassium". ods.od.nih.gov. Archived from the original on 11 August 2022. Retrieved 15 August 2022.
15. He FJ, Markandu ND, Coltart R, Barron J, MacGregor GA (April 2005). "Effect of short-term supplementation of potassium chloride and potassium citrate on blood pressure in hypertensives". Hypertension. 45 (4): 571–574. doi:10.1161/01.HYP.0000158264.36590.19. PMID 15723964.
16. Stubblefield PG, Carr-Ellis S, Borgatta L (July 2004). "Methods for induced abortion". Obstetrics and Gynecology. 104 (1): 174–185. doi:10.1097/01.AOG.0000130842.21897.53. PMID 15229018.
17. "Types of Abortion Procedures". Archived from the original on 18 April 2009.. Americanpregnancy.org (20 September 2011). Retrieved on 16 February 2012.
18. Boyes R (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.
19. Sahimi M. "The Chain Murders: Killing Dissidents and Intellectuals, 1988-1998". pbs.org. FRONTLINE. Archived from the original on 11 December 2016. Retrieved 27 November 2016.