max conc of kcl @ peripheral vein 40meq or 80 meq/l & the rate of administration ??
And the max dose of kcl / day & interval for hypokalemia ??
For peripheral administration, further dilution to a concentration ≤80 mEq/L
For central line infusion, a maximum concentration up to 200 mEq/L (0.2 mEq/mL) has been used for infusions; usual reported concentration is 120 to 150 mEq/L
You should be aware with two different values.
1. Normal mentainance
2. Replacement for hypokalemia
Normal mentainance of potassium is usually about 2 to 4 mEq/kg/day for infants and children and 1 to 2 mEq/kg/day for adolescents. Usually we use the 20 meq/l solution as mentainance to achieve this normal requirement. However this could not be enough for some patients such as fluid restricted patients and patients recovering too much medications so that the volume left for the mentainance solution is too little to achive the usually required K with the concentration of 20meq/l. In such situations, we have to increase the concentration more than 20meq/l according to the usual need for the patient. Remember, we still talking mentainance.
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As replacement, we should add more K according to the status of hydration (is the patient dehydrated? and what type of dehydration). Usually the deficit can be calculated using the following formula:
potassium deficit = fluid deficit (L) × 0.4 x 120 mEq/L
You can read more about this from:
1. ACCP Updates in Therapeutics: Pediatric Pharmacy Preparatory Review and Recertification Course, Fluids and electrolytes chapter.
2. The Harriet Lane Handbook, Fluids and electrolytes chapter.
all your comments and questions are welcome. Please, don’t hesitate to ask for more clarification.
شكرا والله يا دكتور انا فعلا في حاجات كتير مش عارفاها فبلجا لحضراتكم ربنا يجازي حضرتك كل خير وفي ميزان حسنات حضرتك يارب
معلش يا دكتور ممكن بمثال
يعني دلوقت لو في هيبوكاليميا بزود البوتاسيوم ع المحاليل انا اصلا في ال maintenance
بدي ع 20 meq/l
هخليه كده ع ٤٠ meq/l
لو بعد ما زودت لسه قليل اقل مثلا
من ٢
هزود ع المحاليل تاني
ولا بدي بقي انفيوشن كمان كده لوحده
لو عطيت انفيوشن بدي بدوز 1 meq/kg/hr
وبعدها بقيس البوتاسيوم لو فضل قليل ادي تاني انفيوشن
ولا اعمل ايه
يعني الماكسيمم دوز بالضبط في اليوم كام وهل ينفع ادي انفيوشن كذا مرة كده عادي وبين كب مرة ومرة وقت قد ايه مثلا والمفروض أصلح البوتاسيوم ع مدار وقت معين ولا عادي لحد ما يرفع معايا
واسفه ع الازعاج