Generic Name:

Phosphate; Potassium

Trade Name:

Action:

Electrolyte replacement

Indications:

Hypophosphatemia

IV Administration Guidelines:

Usual Dosage Range and Route:

0.08 mmol to 0.36 mmol/kg/dose

Maximum dose 45mmol/24 hrs or 1.5 – 2 mmol/kg/24hrs, whichever is less

Dose should be based on patient's condition and serum phosphate level

Note patient's serum phosphate levels vary by age

Reference MGH Values

0-9.9 days: 4.5-9.0 mg/dL
10 days-1.9 yr: 4.5-6.7 mg/dL
2 yr - 11.9 yr: 4.5-5.5 mg/dL
12 yr - 17.9 yr: 3.0-4.5 mg/dL
Adults: 2.6-4.5 mg/dL

Maximum

Concentrations:

Central: 0.12 mmol/mL

Peripheral: 0.05 mmol/mL

CONCENTRATIONS LIMITED BY POTASSIUM

(POTASSIUM 4.4 mEq = PHOSPHATE 3 mmol)

Rate of Administration

Usual Rate 0.06 mmol/kg/hour, Contact pharmacy if using higher rates

DO NOT EXCEED 6 mmol/hour

Special Considerations:

•  Monitor serum and/or ionized calcium

•  Monitor serum phosphate 4-6 hours after infusion completed

•  For potassium phosphate, all other sources of potassium such as TPN, IV maintenance fluids and oral supplements must be taken into consideration when determining dose and rate of administration

•  Must be infused on a mechanical infusion device

•  Please consult your floor pharmacist for indication specific considerations

Precautions:

•  Rapid IV potassium administration may cause cardiac arrest

•  Use with caution in patients with renal impairment

•  Caution when repleting chronically low phosphate

•  May develop re-feeding syndrome (> 48 hrs NPO) if replaced too quickly (by dose or rate)

Side Effects:

•  EKG changes (prolongation of QRS, peaked T waves)

•  Tetany

•  Hypocalcemia

•  Burning sensation if administered through peripheral access