塩化カリウム / グルコン酸カリウム
Potassium Chloride / Potassium Gluconate
Potassium chloride (KCl), Potassium gluconate
別名: Tumil-K · Renakare · Potassiject · Cal-Dextro K · K-G Elixir · Kaon · Kaylixir · Potasoral · Sopa-K · Ultra-K · KCl · cloreto de potassio · E508 · kalii chloridum · kalium chloratum · E577
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Treatment of chronic mild hypokalemia (3.0-3.5 mEq/L) | 0.5-1 mEq/kg mixed in food once or twice daily | PO | q12-24h | — | 🌎 NA |
| Treatment of chronic mild hypokalemia (Tumil-K powder) | 1/4 teaspoonful (2 mEq) per 4.5 kg body weight in food twice daily; adjust as necessary | PO | q12h | — | 🌎 NA |
| Moderate to severe (<3.0 mEq/L) or acute hypokalemia | Rate should not exceed 0.5 mEq/kg/hour. Under dire circumstances (serum K < 2.0 mEq/L), rate can be increased to 1.5 mEq/kg/hour along with close EKG monitoring. | IV | Continuous | — | 🌎 NA |
| Subcutaneous fluid supplementation (<10 kg patients) | 150 mL SC every 12 hours of isotonic fluids containing 30-35 mEq/L KCl | SC | q12h | — | 🌎 NA |
| Intravenous replacement | Rate not to exceed 0.5 mEq/hour. Concentration of replacement fluid should exceed 60 mEq/L. | IV | Continuous | — | 🌎 NA |
| Oral maintenance supplementation | 2-44 mEq/day depending on body size | PO | Daily | — | 🌎 NA |
| Maintenance IV fluid supplementation | 0.05-0.1 mEq/kg/hour to 0.5 mEq/kg/hour | IV | Continuous | — | 🌎 NA |
| Sliding scale IV supplementation based on Serum K+ | Serum K+ <2 mEq/L = 60 mEq/1000 mL IV fluid; Serum K+ 2-2.5 mEq/L = 40 mEq/1000 mL IV fluid; Serum K+ 2.5-3 mEq/L = 30 mEq/1000 mL IV fluid; Serum K+ 3-3.5 mEq/L = 20 mEq/1000 mL IV fluid. Infusion rates should generally not exceed 0.5 mEq/kg/hour. | IV | Continuous | — | 🌎 NA |
- Treatment of chronic mild hypokalemia (3.0-3.5 mEq/L): Can use commercially available oral supplement tablets and elixirs diluted in water.
- Moderate to severe (<3.0 mEq/L) or acute hypokalemia: Amounts exceeding >10 mEq/hour to a small animal (<10 kg) can be life-threatening via central line.
- Intravenous replacement: Begin oral supplementation as soon as possible.
- Oral maintenance supplementation: Using potassium gluconate.
- Sliding scale IV supplementation based on Serum K+: Higher rates up to 1.5 mEq/kg/hour require continuous ECG monitoring.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Treatment of chronic mild hypokalemia (3.0-3.5 mEq/L) | 0.5-1 mEq/kg mixed in food once or twice daily | PO | q12-24h | — | 🌎 NA |
| Treatment of chronic mild hypokalemia (Tumil-K powder) | 1/4 teaspoonful (2 mEq) per 4.5 kg body weight in food twice daily; adjust as necessary | PO | q12h | — | 🌎 NA |
| Moderate to severe (<3.0 mEq/L) or acute hypokalemia | Rate should not exceed 0.5 mEq/kg/hour. Under dire circumstances (serum K < 2.0 mEq/L), rate can be increased to 1.5 mEq/kg/hour along with close EKG monitoring. | IV | Continuous | — | 🌎 NA |
| Subcutaneous fluid supplementation (<10 kg patients) | 150 mL SC every 12 hours of isotonic fluids containing 30-35 mEq/L KCl | SC | q12h | — | 🌎 NA |
| Oral maintenance supplementation | 2-4 mEq/day | PO | Daily | — | 🌎 NA |
| Sliding scale IV supplementation based on Serum K+ | Serum K+ <2 mEq/L = 60 mEq/1000 mL IV fluid; Serum K+ 2-2.5 mEq/L = 40 mEq/1000 mL IV fluid; Serum K+ 2.5-3 mEq/L = 30 mEq/1000 mL IV fluid; Serum K+ 3-3.5 mEq/L = 20 mEq/1000 mL IV fluid. Infusion rates should generally not exceed 0.5 mEq/kg/hour. | IV | Continuous | — | 🌎 NA |
- Oral maintenance supplementation: Using potassium gluconate.
馬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Counteract potassium depletion in a completely anorectic horse | IV fluids should be supplemented with KCL (at least 50 mEq/hour) | IV | Continuous | — | 🌎 NA |
| Hypokalemia with diarrhea | Hypertonic oral KCL pastes | PO | As needed | — | 🌎 NA |
牛
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Hypokalemia in 'downer' cows | 80 grams sodium chloride and 20 grams potassium chloride in 10 liters of water via stomach tube. Provide a bucket containing similar solution for cow to drink and another containing fresh water. | PO | Once | — | 🌎 NA |
| Hypokalemia maintenance/treatment | 50 grams PO daily; 1 mEq/kg/hour IV drip | PO/IV | Daily/Continuous | — | 🌎 NA |
| Severe hypokalemia (<2.3 mEq/L) with severe muscle weakness or recumbency | Isotonic potassium chloride (11.5 grams of potassium chloride per 1 liter of sterile water) at a rate of 4 mL/kg/hour. Combined with large doses of oral potassium salts (i.e., 200 grams of KCl per day). | IV/PO | Continuous/Daily | — | 🌎 NA |
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
カリウムは生命維持に不可欠な重要な細胞内電解質です。特に心臓、骨格筋、平滑筋などの興奮性組織において、細胞の静止膜電位を維持する上で極めて重要な役割を果たします。
臨床のポイント：
- 低カリウム血症は、慢性腎臓病（特に猫）、積極的な利尿、糖尿病性ケトアシドーシス（DKA）、および重度の消化管からの喪失によく見られる合併症です。
- グルコン酸カリウムは、消化管への刺激が少なく、軽度のアルカリ化作用があるため、通常、経口補給に推奨されます。
- 塩化カリウム（KCl）は静脈内補給の標準ですが、致命的な不整脈を防ぐために投与前に必ず希釈する必要があります。
- 酸塩基平衡異常（アシドーシスはカリウムを細胞外に移動させる）が存在する場合、血清レベルが正常に見えても、全身のカリウム枯渇が重度である可能性があります。
作用機序
Potassium is the principal intracellular cation in the body. It works primarily via the Na+/K+ ATPase pump to maintain the electrochemical gradient across cell membranes.
- Maintains cellular tonicity and resting membrane potential → essential for nerve impulse transmission.
- Regulates smooth, skeletal, and cardiac muscle contraction.
- Acts as a crucial cofactor in carbohydrate utilization and protein synthesis.
- Essential for the maintenance of normal renal function.
安全性・警告
禁忌
- Hyperkalemia
- Renal failure or severe renal impairment
- Severe hemolytic reactions
- Untreated Addison's disease (hypoadrenocorticism)
- Acute dehydration
- GI motility impairment (for solid oral dosage forms)
有害事象
- Hyperkalemia (muscle weakness, cardiac conduction disturbances)
- Gastrointestinal distress (vomiting, diarrhea) with oral therapy
- Vein irritation and phlebitis with IV therapy
注意事項
CRITICAL WARNING: Intravenous potassium salts MUST be diluted before administering and given slowly. Rapid IV administration can cause fatal cardiac arrest.
- Maximum standard IV rate: Generally should not exceed 0.5 mEq/kg/hour. In dire circumstances (<2.0 mEq/L), rates up to 1.5 mEq/kg/hour may be used only with continuous ECG monitoring.
- Assess renal and cardiac function prior to therapy.
- Acid-base balance masks the actual potassium picture: acidosis causes a false elevation (shifts K+ out of cells), while alkalosis causes a falsely low serum value.
- Supplementation should generally occur over 3-5 days to allow equilibration between extracellular and intracellular fluids.
- Use cautiously in digitalized patients.
医薬品相互作用
Potassium retention may occur; increased risk for hyperkalemia.
In patients with severe or complete heart block receiving digitalis therapy, it is often recommended not to use potassium salts.
Oral potassium given with non-steroidal anti-inflammatory agents may increase the risk of gastrointestinal adverse effects.
Potassium retention may occur; increased risk for hyperkalemia.
監視
- Serum potassium levels
- Other electrolytes (sodium, chloride, magnesium, calcium)
- Acid/base status
- Blood glucose
- ECG (especially during IV administration)
- CBC
- Urinalysis and renal function parameters
薬物動態
吸収
Readily absorbed from the gastrointestinal tract when administered orally.
分布
Approximately 98% of total body potassium is found in the intracellular fluid space, while only 2% is in the extracellular fluid space. Plasma pH alters distribution: acidosis shifts potassium out of the intracellular space, and alkalosis shifts potassium into the intracellular space.
代謝
Potassium is an elemental ion and is not metabolized.
消失
Primarily (80-90%) excreted via the kidneys, with the majority of the remainder excreted in the feces. Very small amounts may be excreted in perspiration (in animals with sweat glands).
過剰投与
Fatal hyperkalemia may develop if potassium salts are administered too rapidly IV or if potassium renal excretory mechanisms are impaired.
Clinical Signs of Hyperkalemia:
- Muscular weakness
- Gastrointestinal disturbances
- Severe cardiac conduction disturbances (bradycardia, atrial standstill, ventricular fibrillation, asystole)
Treatment of Hyperkalemia:
- Immediate discontinuation of the potassium supplement.
- Continuous ECG, acid/base, and electrolyte monitoring.
- Medical interventions: Glucose/insulin infusions (drives K+ into cells), sodium bicarbonate (alkalinization drives K+ into cells), calcium therapy (cardioprotective, antagonizes K+ effects on the heart), and polystyrene sulfonate resin (binds K+ in the GI tract).
製品
製剤
- Intravenous injection concentrate
- Oral tablets
- Oral powder
- Oral gel
- Oral liquid/elixir
動物用医薬品
- Potassium Chloride IV Solution: 2 mEq (149 mg) in 10 mL vials (Potassiject)
- Potassium Gluconate Tablets: 2 mEq (468 mg) (Tumil-K, Renakare)
- Potassium Gluconate Oral Powder: 2 mEq per 0.65 gram (1/4 tsp) (Tumil-K, Renakare)
- Potassium Gluconate Gel: 2 mEq per 2.34 grams (1/2 tsp) (Tumil-K Gel, Renakare)
ヒト用医薬品
- Potassium Chloride for Injection Concentrate: 2 mEq/mL in various vial sizes (Must be diluted)
- Potassium Chloride Tablets, controlled/sustained release tablets and capsules
- Potassium Chloride effervescent tablets, liquids, and powders
規制ステータス
規制データなし: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Potassium gluconate oral products and potassium chloride products should be stored in tight, light-resistant containers at room temperature (15-30°C). Protect potassium chloride solutions from freezing.
飼主向け情報
重要： 獣医師の明確な指示なしに、人間用のカリウムサプリメントをペットに与えないでください。投与量は非常に厳密であり、過剰投与は致命的になる可能性があります。
- 投与方法： 胃の不快感を防ぎ、嗜好性を高めるために、経口用の粉末、ゲル、または液体をペットの食事にしっかりと混ぜてください。
- 食事の拒否： ペットが薬の入った食事を拒否した場合は、獣医師に連絡してください。無理に食べさせたり、次回の投与量を2倍にしたりしないでください。
- 観察： 筋力低下、重度の無気力、嘔吐、または下痢の兆候がないか観察してください。これらの症状が現れた場合は、すぐに獣医師に連絡してください。
- すべてのカリウムサプリメントは、子供や他のペットの手の届かない場所に保管してください。
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