Adult: For treatment and prophylaxis: Normal daily requirements: 40-80 mEq/24 hour, given via infusion at a max rate of 1 mEq/kg/hour. Dose and rate of administration are dependent upon the ECG and serum K levels. Child: For treatment and prophylaxis: Normal daily requirements: 2-3 mEq/kg/24 hour; Newborn: 2-6 mEq/kg/24 hour. Dose and rate of administration are dependent upon the ECG and serum K levels. Max infusion rate: 1 mEq/kg/hour.
Reconstitution
Potassium acetate should be diluted to a final concentration approx 10-40 mEq/100 mL with dextrose 5 or 10% inj or dextrose 5% in lactated Ringer’s, NaCl 0.9%, lactated Ringer’s, Hartmann’s solution.
Contraindications
Hyperkalaemia and associated diseases. Adrenal insufficiency. Severe renal impairment.
Special Precautions
Patient with acid-base alterations, metabolic or respiratory alkalosis, dehydration, hyperkalaemia, K-altering conditions (e.g. heat cramps, severe tissue breakdown from trauma or burns), cardiac disease (e.g. cardiac arrhythmias, heart block, CHF). Severe hepatic and mild to moderate renal impairment. Pregnancy and lactation.
Adverse Reactions
Significant: Hyperkalaemia, alkalosis. Injury, poisoning and procedural complications: Inj site pain, phlebitis, extravasation. Potentially Fatal: Severe hyperkalaemia.
Monitor serum electrolytes including K, bicarbonate and Mg levels; ECG, and acid-base status. Assess adequate replacement, repeat serum K test 2-4 hr after admin. Monitor infusion site reactions (e.g. extravasation).
Overdosage
Symptoms: Fatal hyperkalaemia, manifested by increased serum K concentration and ECG changes and may lead to cardiac depression, arrhythmias or arrest. Management: Discontinue K acetate; agents and food containing K or which increases serum K levels. Correct acidosis with Na bicarbonate infusion. Manage cardiac toxicity with Ca gluconate. Continuously monitor ECG. In severe cases, haemodialysis, or peritoneal dialysis, or exchange resin treatment may be necessary.
Drug Interactions
May increase hyperkalaemic effect of K sparing diuretics (e.g. amiloride), ACE inhibitors (e.g. captopril), K-containing salts. Potentially Fatal: May increase risk of cardiotoxicity with digoxin.
Action
Description: Mechanism of Action: Potassium acetate acts as an electrolyte replenisher of K ions. K, the major cation of the intracellular fluid, is essential for maintenance of acid-base and fluid and electrolyte balance of the cell. It also plays a vital role in the conduction of nerve impulses, contraction of cardiac, smooth and skeletal muscles, gastric secretion, normal renal function and carbohydrate metabolism. Pharmacokinetics: Distribution: Distributed to cells via active transport from extracellular fluid. Enters breast milk. Excretion: Mainly via urine; faeces and sweat (small amount).
Chemical Structure
Potassium acetate Source: National Center for Biotechnology Information. PubChem Database. Potassium acetate, CID=517044, https://pubchem.ncbi.nlm.nih.gov/compound/Potassium-acetate (accessed on Jan. 23, 2020)
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