Potassium chloride (medical use): Difference between revisions
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Improving style. The frequency of the use of KCl in abortion was not discussed in the quoted sources, which are outdated anyway, so changing 'rarely' to 'sometimes.' Abortion and execution are uses of potassium chloride, not side effects or cultural context, and they should be discussed under the heading of medical uses. Tags: Visual edit Mobile edit Mobile web edit |
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'''Potassium chloride''', also known as '''potassium salt''', is used as a medication to treat and prevent [[low blood potassium]].<ref name=WHO2008/> Low blood potassium may occur due to [[vomiting]], [[diarrhea]], or certain medications.<ref name=MTM2017>{{cite web|title=Potassium chloride medical facts from Drugs.com|url=https://www.drugs.com/mtm/potassium-chloride.html|website=www.drugs.com|accessdate=14 January 2017| |
'''Potassium chloride''', also known as '''potassium salt''', is used as a medication to treat and prevent [[low blood potassium]].<ref name=WHO2008/> Low blood potassium may occur due to [[vomiting]], [[diarrhea]], or certain medications.<ref name=MTM2017>{{cite web|title=Potassium chloride medical facts from Drugs.com|url=https://www.drugs.com/mtm/potassium-chloride.html|website=www.drugs.com|accessdate=14 January 2017|url-status=live|archiveurl=https://web.archive.org/web/20170118040410/https://www.drugs.com/mtm/potassium-chloride.html|archivedate=18 January 2017}}</ref> The concentrated version should be diluted before use.<ref name=WHO2008>{{cite book|title=WHO Model Formulary 2008|date=2009|publisher=World Health Organization|isbn=9789241547659|page=491|url=http://apps.who.int/medicinedocs/documents/s16879e/s16879e.pdf|accessdate=8 January 2017|url-status=live|archiveurl=https://web.archive.org/web/20161213060118/http://apps.who.int/medicinedocs/documents/s16879e/s16879e.pdf|archivedate=13 December 2016}}</ref> It is given by [[intravenous infusion|slow injection into a vein]] or by mouth.<ref name=BNF69/> |
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Side effects may include heart problems if given too quickly by injection into a vein.<ref name=BNF69>{{cite book|title=British national formulary : BNF 69|date=2015|publisher=British Medical Association|isbn=9780857111562|page=680, 684|edition=69}}</ref> By mouth it can result in abdominal pain, [[peptic ulcer disease]], or [[gastrointestinal bleeding]].<ref name=BNF69/> Greater care is recommended in those with [[kidney problems]].<ref name=WHO2008/> As long as [[high blood potassium]] does not occur, use in [[pregnancy]] or [[breastfeeding]] is believed to be safe for the baby.<ref>{{cite web|title=Klor-Con M - FDA prescribing information, side effects and uses|url=https://www.drugs.com/pro/klor-con-m.html|website=www.drugs.com|accessdate=14 January 2017| |
Side effects may include heart problems if given too quickly by injection into a vein.<ref name=BNF69>{{cite book|title=British national formulary : BNF 69|date=2015|publisher=British Medical Association|isbn=9780857111562|page=680, 684|edition=69}}</ref> By mouth it can result in abdominal pain, [[peptic ulcer disease]], or [[gastrointestinal bleeding]].<ref name=BNF69/> Greater care is recommended in those with [[kidney problems]].<ref name=WHO2008/> As long as [[high blood potassium]] does not occur, use in [[pregnancy]] or [[breastfeeding]] is believed to be safe for the baby.<ref>{{cite web|title=Klor-Con M - FDA prescribing information, side effects and uses|url=https://www.drugs.com/pro/klor-con-m.html|website=www.drugs.com|accessdate=14 January 2017|url-status=live|archiveurl=https://web.archive.org/web/20170118035954/https://www.drugs.com/pro/klor-con-m.html|archivedate=18 January 2017}}</ref> Generally, the strength of the formulation for injection into a vein should not be greater than 40 mmol/l (3 mg/l).<ref name=BNF69/> |
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[[Potassium chloride]] came into large scale commercial use as a [[fertilizer]] in 1861 and has been used medically since the 1950s.<ref>{{cite book|last1=Velde|first1=Pierre|last2=Barré|first2=Pierre|title=Soils, Plants and Clay Minerals: Mineral and Biologic Interactions|date=2009|publisher=Springer Science & Business Media|isbn=9783642034992|page=275|url=https://books.google.com/books?id=YKkw-Bre-kAC&pg=PA275|language=en| |
[[Potassium chloride]] came into large scale commercial use as a [[fertilizer]] in 1861 and has been used medically since the 1950s.<ref>{{cite book|last1=Velde|first1=Pierre|last2=Barré|first2=Pierre|title=Soils, Plants and Clay Minerals: Mineral and Biologic Interactions|date=2009|publisher=Springer Science & Business Media|isbn=9783642034992|page=275|url=https://books.google.com/books?id=YKkw-Bre-kAC&pg=PA275|language=en|url-status=live|archiveurl=https://web.archive.org/web/20170918185415/https://books.google.com/books?id=YKkw-Bre-kAC&pg=PA275|archivedate=2017-09-18}}</ref><ref>{{cite book|title=BNA's Patent, Trademark & Copyright Journal|date=1991|publisher=Bureau of National Affairs, Incorporated|url=https://books.google.com/books?id=h1soAQAAMAAJ&q|language=en|quote=Potassium chloride, used since the 1950s for the treatment of potassium depletion in humans|url-status=live|archiveurl=https://web.archive.org/web/20170918185415/https://books.google.com/books?id=h1soAQAAMAAJ&q|archivedate=2017-09-18}}</ref> It is on the [[World Health Organization's List of Essential Medicines]], the most effective and safe medicines needed in a [[health system]].<ref name=WHO19th>{{cite web|title=WHO Model List of Essential Medicines (19th List)|url=http://www.who.int/medicines/publications/essentialmedicines/EML_2015_FINAL_amended_NOV2015.pdf?ua=1|work=World Health Organization|accessdate=8 December 2016|date=April 2015|url-status=live|archiveurl=https://web.archive.org/web/20161213052708/http://www.who.int/medicines/publications/essentialmedicines/EML_2015_FINAL_amended_NOV2015.pdf?ua=1|archivedate=13 December 2016}}</ref> Potassium chloride is available as a [[generic medication]].<ref name=BNF69/> The wholesale cost in the [[developing world]] is about 0.44 USD per 10 ml of 10% solution.<ref name=ERC2014>{{cite web|title=Potassium Chloride|url=http://mshpriceguide.org/en/single-drug-information/?DMFId=641&searchYear=2014|website=International Drug Price Indicator Guide|accessdate=8 December 2016}}</ref> In the United Kingdom 10 ml of 15% solution costs the [[NHS]] about 0.48 pounds.<ref name=BNF69/> In 2016 it was the 33rd most prescribed medication in the United States with more than 22 million prescriptions.<ref>{{cite web |title=The Top 300 of 2019 |url=https://clincalc.com/DrugStats/Top300Drugs.aspx |website=clincalc.com |accessdate=22 December 2018}}</ref> |
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==Medical use== |
==Medical use== |
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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 abortion]]s.<ref>{{cite journal |last1=Stubblefield |first1=Phillip G. |last2=Carr-Ellis |first2=Sacheen |last3=Borgatta |first3=Lynn |title=Methods for Induced Abortion |journal=Obstetrics & Gynecology |volume=104 |issue=1 |pages=174–85 |year=2004 |pmid=15229018 |doi=10.1097/01.AOG.0000130842.21897.53 }}</ref><ref>[http://www.americanpregnancy.org/unplannedpregnancy/abortionprocedures.html Types of Abortion Procedures] {{webarchive|url=https://web.archive.org/web/20090418010448/http://www.americanpregnancy.org/unplannedpregnancy/abortionprocedures.html |date=2009-04-18 }}. Americanpregnancy.org (2011-09-20). Retrieved on 2012-02-16.</ref> [[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.<ref>{{cite news| last = Boyes| first = Roger| title = Death for hire – suicide machine lets you push final button| publisher = The Times| date = March 29, 2008| url = http://www.thetimes.co.uk/tto/news/world/europe/article2596816.ece}}</ref> |
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 abortion]]s.<ref>{{cite journal |last1=Stubblefield |first1=Phillip G. |last2=Carr-Ellis |first2=Sacheen |last3=Borgatta |first3=Lynn |title=Methods for Induced Abortion |journal=Obstetrics & Gynecology |volume=104 |issue=1 |pages=174–85 |year=2004 |pmid=15229018 |doi=10.1097/01.AOG.0000130842.21897.53 }}</ref><ref>[http://www.americanpregnancy.org/unplannedpregnancy/abortionprocedures.html Types of Abortion Procedures] {{webarchive|url=https://web.archive.org/web/20090418010448/http://www.americanpregnancy.org/unplannedpregnancy/abortionprocedures.html |date=2009-04-18 }}. Americanpregnancy.org (2011-09-20). Retrieved on 2012-02-16.</ref> [[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.<ref>{{cite news| last = Boyes| first = Roger| title = Death for hire – suicide machine lets you push final button| publisher = The Times| date = March 29, 2008| url = http://www.thetimes.co.uk/tto/news/world/europe/article2596816.ece}}</ref> |
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Cardiac arrest induced by potassium has been used in political assassinations in Iran, by [[Chain murders of Iran|injection]] or by inserting a potassium suppository into the victim's rectum.<ref>{{cite web|last1=Sahimi|first1=Muhammad|title=The Chain Murders: Killing Dissidents and Intellectuals, 1988-1998|url=https://www.pbs.org/wgbh/pages/frontline/tehranbureau/2011/01/the-chain-murders-killing-dissidents-and-intellectuals-1988-1998.html|website=pbs.org|publisher=FRONTLINE|accessdate=27 November 2016| |
Cardiac arrest induced by potassium has been used in political assassinations in Iran, by [[Chain murders of Iran|injection]] or by inserting a potassium suppository into the victim's rectum.<ref>{{cite web|last1=Sahimi|first1=Muhammad|title=The Chain Murders: Killing Dissidents and Intellectuals, 1988-1998|url=https://www.pbs.org/wgbh/pages/frontline/tehranbureau/2011/01/the-chain-murders-killing-dissidents-and-intellectuals-1988-1998.html|website=pbs.org|publisher=FRONTLINE|accessdate=27 November 2016|url-status=live|archiveurl=https://web.archive.org/web/20161211122508/http://www.pbs.org/wgbh/pages/frontline/tehranbureau/2011/01/the-chain-murders-killing-dissidents-and-intellectuals-1988-1998.html|archivedate=11 December 2016}}</ref> |
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==References== |
==References== |
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Revision as of 19:22, 30 September 2019
| Clinical data | |
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| Trade names | Kay-Cee-L, Slow-K, others |
| AHFS/Drugs.com | Multum Consumer Information |
| ATC code | |
| Legal status | |
| Legal status | |
| Identifiers | |
| CAS Number | |
| PubChem CID | |
| DrugBank | |
| ChemSpider | |
| UNII | |
| KEGG | |
| ChEBI | |
| ChEMBL | |
| Chemical and physical data | |
| Formula | KCl |
| Molar mass | 74.5513 |
| 3D model (JSmol) | |
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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, the most effective and safe medicines needed in a health system.[8] Potassium chloride is available as a generic medication.[4] The wholesale cost in the developing world is about 0.44 USD per 10 ml of 10% solution.[9] In the United Kingdom 10 ml of 15% solution costs the NHS about 0.48 pounds.[4] In 2016 it was the 33rd most prescribed medication in the United States with more than 22 million prescriptions.[10]
Medical use
Potassium chloride is used in the treatment of hypokalemia as an electrolyte replenisher.[11] With a molecular weight of approximately 75 and a valence of 1, the use of KCl for electrolytes makes 75 mg the equivalent of 1 mEq.
Some cardiac surgery procedures cannot be carried out on the beating heart. For these procedures, the surgical team will bypass the heart with a heart-lung machine and inject potassium chloride into the heart muscle to stop the heartbeat.
Side effects
Side effects can include gastrointestinal discomfort, including nausea and vomiting, diarrhea, and bleeding of the digestive tract.
Overdoses cause hyperkalemia, which can lead to paresthesia, cardiac conduction blocks, fibrillation, arrhythmias, and sclerosis.[12] Because of the danger of hyperkalemia, the US FDA limits the amount of potassium supplements to 99 mg (about 1.3 mEq) 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.[13]
Society
Brand names
Brand names include K-Dur, Klor-Con, Micro-K, Slow-K, Sando-K and Kaon Cl, most of which are extended release medicine by mouth.
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.[14][15] 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.[16]
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.[17]
References
- ^ "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 Oct 2023.
- ^ a b c WHO Model Formulary 2008 (PDF). World Health Organization. 2009. p. 491. ISBN 9789241547659. Archived (PDF) from the original on 13 December 2016. Retrieved 8 January 2017.
- ^ "Potassium chloride medical facts from Drugs.com". www.drugs.com. Archived from the original on 18 January 2017. Retrieved 14 January 2017.
- ^ a b c d e f British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 680, 684. ISBN 9780857111562.
- ^ "Klor-Con M - FDA prescribing information, side effects and uses". www.drugs.com. Archived from the original on 18 January 2017. Retrieved 14 January 2017.
- ^ Velde, Pierre; Barré, Pierre (2009). Soils, Plants and Clay Minerals: Mineral and Biologic Interactions. Springer Science & Business Media. p. 275. ISBN 9783642034992. Archived from the original on 2017-09-18.
- ^ BNA's Patent, Trademark & Copyright Journal. Bureau of National Affairs, Incorporated. 1991. Archived from the original on 2017-09-18.
Potassium chloride, used since the 1950s for the treatment of potassium depletion in humans
- ^ "WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.
- ^ "Potassium Chloride". International Drug Price Indicator Guide. Retrieved 8 December 2016.
- ^ "The Top 300 of 2019". clincalc.com. Retrieved 22 December 2018.
- ^ Hypokalemia in Emergency Medicine~treatment at eMedicine
- ^ Hyperkalemia in Emergency Medicine at eMedicine
- ^ He, F. J.; Markandu, N. D.; Coltart, R.; Barron, J.; MacGregor, G. A. (2005). "Effect of Short-Term Supplementation of Potassium Chloride and Potassium Citrate on Blood Pressure in Hypertensives". Hypertension. 45 (4): 571–4. doi:10.1161/01.HYP.0000158264.36590.19. PMID 15723964.
- ^ Stubblefield, Phillip G.; Carr-Ellis, Sacheen; Borgatta, Lynn (2004). "Methods for Induced Abortion". Obstetrics & Gynecology. 104 (1): 174–85. doi:10.1097/01.AOG.0000130842.21897.53. PMID 15229018.
- ^ Types of Abortion Procedures Archived 2009-04-18 at the Wayback Machine. Americanpregnancy.org (2011-09-20). Retrieved on 2012-02-16.
- ^ Boyes, Roger (March 29, 2008). "Death for hire – suicide machine lets you push final button". The Times.
- ^ Sahimi, Muhammad. "The Chain Murders: Killing Dissidents and Intellectuals, 1988-1998". pbs.org. FRONTLINE. Archived from the original on 11 December 2016. Retrieved 27 November 2016.