Home Drug Guide Potassium Citrate

Drug Guide

Generic Name

Potassium Citrate

Brand Names Urocit-K

Classification

Therapeutic: Electrolyte Supplement, Urinary Alkalinizer

Pharmacological: Potassium Salt of Citrate

FDA Approved Indications

Prevention and treatment of kidney stones (urolithiasis) caused by or associated with hypocitraturia
Metabolic acidosis (off-label use)

Mechanism of Action

Potassium citrate acts as a urinary alkalinizer by increasing urinary pH and citrate levels, which can bind calcium and reduce calcium stone formation. It also replenishes potassium in cases of deficiency.

Dosage and Administration

Adult: Typically, 15 to 30 mEq of potassium citrate two to four times daily, adjusted according to patient response and serum potassium levels.

Pediatric: Dosing varies based on age and weight; usually, 0.3 to 0.5 mEq/kg per dose, given 2-4 times daily, with close monitoring.

Geriatric: Use with caution; monitor serum potassium and renal function due to risk of hyperkalemia and renal impairment.

Renal Impairment: Adjust dose; use with caution as impaired renal function increases risk of hyperkalemia.

Hepatic Impairment: No specific adjustment required.

Pharmacokinetics

Absorption: Rapidly absorbed from the gastrointestinal tract.

Distribution: Distributed widely in total body water, predominantly in the extracellular fluid.

Metabolism: Not metabolized; excreted unchanged.

Excretion: Excreted by the kidneys. Kidney function affects elimination.

Half Life: Variable; approximately 1-3 hours, depending on urinary pH and renal function.

Contraindications

Hyperkalemia
Renal impairment or urinary tract obstructions
Signs of adrenal insufficiency

Precautions

Regular monitoring of serum potassium and renal function recommended; caution in patients with cardiac disease, adrenal insufficiency, or conditions predisposing to hyperkalemia. Use during pregnancy and lactation should be under medical supervision.

Adverse Reactions - Common

Hyperkalemia (Less common but serious if unmonitored)
Gastrointestinal discomfort (nausea, diarrhea) (Common)

Adverse Reactions - Serious

Arrhythmias due to hyperkalemia (Rare)
Metabolic disturbances (hypernatremia, hypokalemia if imbalance occurs) (Rare)

Drug-Drug Interactions

Potassium-sparing diuretics, ACE inhibitors, ARBs increase risk of hyperkalemia.
NSAIDs may impair renal function and potassium excretion.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor serum electrolytes, renal function, and cardiac status.

Diagnoses:

Risk for electrolyte imbalance
Risk for cardiac arrhythmias

Implementation: Administer with food if gastrointestinal upset occurs; ensure adequate hydration; monitor for signs of hyperkalemia.

Evaluation: Serum potassium levels within acceptable range; patient's symptoms and cardiac rhythm remain stable.

Patient/Family Teaching

Take medication exactly as prescribed.
Report symptoms of hyperkalemia such as muscle weakness, irregular heartbeat, or numbness.
Maintain hydration and dietary potassium intake as advised.
Avoid excessive use of potassium-containing salt substitutes.

Special Considerations

Black Box Warnings:

Risk of severe hyperkalemia, which can be life-threatening.

Genetic Factors: N/A

Lab Test Interference: May elevate serum bicarbonate and potassium levels, affecting blood chemistry results.

Overdose Management

Signs/Symptoms: Hyperkalemia: muscle weakness, paresthesia, arrhythmia.

Treatment: Discontinue potassium source, administer calcium gluconate for cardiac stabilization, use sodium bicarbonate, glucose and insulin, or dialysis in severe cases.

Storage and Handling

Storage: Store at room temperature, away from moisture and heat.

Stability: Stable under recommended storage conditions.