Drug information of Potassium Phosphate


Potassium Phosphate

Drug group:

Brand drugs:K-Phos

Mechanism of effect

Phosphorus is involved in many biochemical functions in the body and significant metabolic and enzyme reactions in almost all organs and tissues; it exerts a modifying influence on the steady state of calcium levels, a buffering effect on acid-base equilibrium, and a primary role in the renal excretion of hydrogen ion.

Potassium is the principal intracellular cation; it helps transport dextrose across the cell membrane and contributes to normal renal function.

Pharmacokinetics

Absorption:Well absorbed from upper GI tract

Distribution:Enters cells via active transport from extracellular fluid

Excretion:Primarily urine (>80% to 90% of dose reabsorbed by the kidney); skin and feces (small amounts)

Drug indications

-Injection: Treatment and prevention of hypophosphatemia.

-Oral: To acidify the urine to lower urinary calcium concentrations; reduce odor and rash caused by ammonia in urine; to increase the antibacterial activity of methenamine.

Dosage

Hypophosphatemia

The dose and administration IV infusion rate for potassium phosphates are dependent upon individual needs of the patient

 Phosphorous serum level <0.5 mg/dL: 0.5 mmol/kg IV infused over 4-6 hr

Phosphorous serum level 0.5-1 mg/dL: 0.25 mmol/kg IV infused over 4-6 hr

Prevention of hypophosphatemia (eg, in TPN): 20-40 mmol/day IV admixed in TPN is typical dose, but adjustment according to electrolyte levels is ongoing

-Urine acidification:

 Oral: 1,000 mg 4 times daily

Hypophosphatemia,pediatric:

Caution should be exercised in premature neonates due to aluminum toxicity

The dose and administration IV infusion rate for potassium phosphates are dependent upon individual needs of the patient

Phosphorous serum level <0.5 mg/dL: 0.5 mmol/kg IV infused over 4-6 hr

Phosphorous serum level 0.5-1 mg/dL: 0.25 mmol/kg IV infused over 4-6 hr

Prevention of hypophosphatemia (eg, in TPN): pediatric

  • Infants/children: 0.5-2 mmol/kg/day IV
  • Children >50 kg or adolescents: 10-40 mmol/day IV
  • Dose adjustment according to electrolyte levels is ongoing

Drug contraindications

- Hyperphosphatemia

- Hyperkalemia

- Hypocalcemia

- Hypomagnesemia

Side effects

Bradycardia, cardiac arrhythmia, chest pain, ECG changes, edema, heart block, hypotension, localized phlebitis,Confusion, lethargy, paralysis, paresthesia,Hyperkalemia,Diarrhea, nausea, stomach pain, vomiting,Decreased urine output,Tetany (with large doses of phosphate), weakness,Acute renal failure,Dyspnea.

Aliskiren ,Alpha-/Beta-Agonists (Indirect-Acting) ,

Amantadine ,Amphetamines ,Angiotensin II Receptor Blockers ,Angiotensin-Converting Enzyme Inhibitors ,

Antacids ,Burosumab ,Calcium Salts ,ChlorproPAMIDE ,

Drospirenone ,Eplerenone ,Erdafitinib ,Heparin ,

Heparins (Low Molecular Weight) ,Iron Preparations ,

Magnesium Salts ,Mecamylamine ,

Multivitamins/Minerals (with ADEK, Folate, Iron),

Nicorandil , Potassium-Sparing Diuretics ,Salicylates ,

Sucralfate

Alerts

- To avoid hyperkalemia or hyperphosphatemia, infuse IV solutions containing potassium phosphates slowly

-Caution with severe renal or adrenal insufficiency due to risk for hyperkalemia or hyperphosphatemia

-High concentrations of phosphorus may cause hypocalcemia and hypocalcemic tetany; monitor calcium levels

- This product contains aluminum that may be toxic

- Extravasation: Vesicant/irritant (may depend on concentration)

- Use with caution in patients with acid/base alterations

- Use with caution in patients with adrenal insufficiency, cardiovascular disease, acute dehydration, myotonia congenital, acute pancreatitis, hypoparathyroidism, Renal calculi, Renal impairment, Rickets, Tissue breakdown

Points of recommendation

- Must be diluted and thoroughly mixed before administration

- Phosphorus replacement therapy with potassium phosphates should be guided primarily by the serum inorganic phosphorus levels and the limits imposed by the accompanying potassium (K+) ion

- Injection must be diluted in appropriate IV solution and volume prior to administration

- The concomitant amount of potassium must be calculated into the total electrolyte content. For each 1 mmol of phosphate, ~1.5 mEq of potassium will be administered

- A mild laxative effect may occur with oral use within the first few days of therapy

Pregnancy level

C

Breast feeding warning

Unknown whether distributed in breast milk.

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