Monograph: |
Potassium Sulphate
Bach g of potassium sulphate represents approximately
1 1.5 nunol of potassium. Potassium sulphate 4.46 g is ap-
proximately equivalent to I g of potassium.
Adverse Effects
Excessive administration of potassium may lead to
the development of hyperkalaemia, especially in pa-
tients with renal impairment. Symptoms include
paraesthesia of the extremities, muscle weakness.
paralysis, cardiac arrhythmias, heart block, cardiac
arrest, and mental confusion. Cardiac toxicity is of
particular concern after intravenous administration.
Pain or phlebitis may occur during intravenous ad-
ministration via the peripheral route, particularly at
higher concentrations.
Nausea, vomiting, diarrhoea, and abdominal cramps
may occur following oral administration of potassi-
um salts. There have been numerous reports of gas-
tro-intestinal ulceration, sometimes with
haemorrhage and perforation or with the late forma-
tion of strictures, after the use of enteric-coated tab-
lets of potassium chloride. Ulceration has also
occurred after the use of sustained-release tablets.
Treatment of Adverse Effects
In mild hyperkalaemia that has developed on long-term treatment,
discontinuation of the potassium supplement and
other drugs that may increase plasma-potassium
concentrations, and avoidance of foods with a high
potassium content may be sufficient to correct the
hyperkalaemia.
In cases of acute oral overdosage of potassium sup-
plements, the stomach should be emptied by gastric
lavage in addition to the measures taken otherwise.
Precautions
Potassium salts should be administered with consid-
erable care to patients with cardiac disease or condi-
tions predisposing to hyperkalaemia such as renal or
adrenocortical insufficiency, acute dehydration, or
extensive tissue destruction as occurs with severe
bums. Excessive use of potassium-containing salt
substitutes or potassium supplements may lead to
accumulation of potassium especially in patients
with renal insufficiency. Regular monitoring of clin-
ical status, serum electrolytes, and the ECG is advis-
able in patients receiving potassium therapy,
particularly those with cardiac or renal impairment.
Liquid or effervescent preparations are preferred to
solid dosage forms for oral administration; use of
the former, with or after food, may reduce gastric
irritation. Solid oral dosage forms of potassium salts
should not be administered to patients with gastro-
intestinal ulceration or obstruction. They should be
given with caution to patients in whom passage
through the gastro-intestinal tract may be delayed,
as in pregnant patients. Treatment should be discon-
tinued if severe nausea, vomiting, or abdominal dis-
tress develops.
Potassium chloride should not be used in patients
with hyperchloraemia.
Direct injection of potassium chloride concentrates
intended for dilution before use may
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