sly fatal. the administration of intravenous solutions can cause fluid and/or solute overload resulting in dilution of serum electrolyte concentrations, overhydration, congested states or pulmonary edema. the risk of dilutional states is inversely proportional to the electrolyte concentration. the risk of solute overload causing congested states with peripheral and pulmonary edema is directly proportional to the electrolyte concentration. to avoid potassium intoxication, do not infuse these solutions rapidly. in patients with renal insufficiency, administration of potassium chloride may cause potassium intoxication and life-threatening hyperkalemia. in patients with diminished renal function, administration of solutions containing potassium ions may result in potassium retention.

ation to peripheral or central veins. for peripheral administration of solutions containing potassium, slowly infuse the solution through a small bore needle, placed well within the lumen of a large vein. carefully avoid infiltration. solutions containing dextrose should be used with caution in patients with overt or known subclinical diabetes mellitus, or carbohydrate intolerance for any reason. if the administration is controlled by a pumping device, care must be taken to discontinue pumping action before the container runs dry or air embolism may result. to minimize the risk of possible incompatibilities arising from mixing this solution with other additives that may be prescribed, the final infusate should be inspected for cloudiness or precipitation immediately after mixing, prior to administration, and periodically during administration. use only if solution is clear and vacuum is present. discard the container no later than 4 hours after initial closure puncture.

t exceed 200 meq. if urgent treatment is indicated (serum potassium level less than 2.0 meq/liter and electrocardiographic changes and/or muscle paralysis), potassium chloride may be infused very cautiously at a rate of up to 40 meq/hour. in such cases, continuous cardiac monitoring is essential. as much as 400 meq may be administered in a 24 hour period. in critical conditions, potassium chloride may be administered in saline (unless contraindicated) rather than in dextrose containing fluids, as dextrose may lower serum potassium levels. parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. directions for use of pharmacy bulk package in b. braun glass containers with solid stoppers warning: not for direct infusion. for preparation of admixtures for intravenous infusion. the pharmacy bulk package is for use in a pharmacy admixture service only. use of this product is restricted to a suitable work area, such as a laminar flow hood (or an equivalent clean air compounding area). additives should not be made to pharmacy bulk packages. designed for use with a vented sterile dispensing set. before use, perform the following checks: inspect each container. read the label. ensure solution is the one ordered and is within the expiration date. verify that closure is black and is printed with the words "must be diluted". invert container and carefully inspect the solution in good light for cloudiness, haze, or particulate matter; check the bottle for cracks or other damage. in checking for cracks, do not be confused by normal surface marks and seams on bottom and sides of bottle. these are not flaws. look for bright reflections that have depth and penetrate into the wall of the bottle. reject any such bottle. remove plastic cap (see figure 1). swab exposed stopper surface with a suitable disinfectant. check for vacuum at first puncture of the stopper. insert the spike fully into the target area of the rubber stopper (see figure 2) and promptly invert the bottle. verify vacuum by observing rising air bubbles. do not use the bottle if vacuum is not present. refer to directions for use of set to be used. if set insertion is not performed immediately following swabbing, swab stopper again with a suitable disinfectant. the container closure may be penetrated only one time, utilizing a suitable sterile dispensing set which allows measured dispensing of the contents. transfer individual dose(s) to appropriate intravenous infusion solutions. use of a syringe with needle is not recommended. multiple entries increase the potential of the microbial and particulate contamination. the withdrawal of container contents should be accomplished without delay using aseptic technique. discard container no later than 4 hours after initial closure puncture. the bottle may be stored under laminar flow hood at room temperature (25°c) after the closure has been entered. date and time of container entry should be noted in the area designated on the container label. figure 1 illustration figure 2 illustration

y cause a loss of bicarbonate ions, resulting in an acidifying effect. potassium-containing solutions are intrinsically irritating to tissues. therefore, extreme care should be taken to avoid perivascular infiltration. local tissue necrosis and subsequent sloughing may result if extravasation occurs. chemical phlebitis and venospasm have also been reported. if an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures and save the remainder of the fluid for examination if deemed necessary.