DEXTROSE 10% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides a source of calories and carbohydrate for metabolism, preventing ketosis and promoting protein-sparing. Sodium chloride provides electrolytes to maintain osmotic pressure and fluid balance.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle to carbon dioxide and water, yielding energy (ATP). Sodium chloride is not metabolized; it is excreted primarily by the kidneys. |
| Excretion | Renal: nearly 100% as free water and electrolytes. Dextrose is completely metabolized to CO2 and water; no significant biliary or fecal elimination. |
| Half-life | Dextrose: ~2.3 hours (intracellular utilization). Sodium chloride: not applicable; electrolytes are regulated homeostatically. Clinically, dextrose's half-life reflects rapid cellular uptake. |
| Protein binding | Dextrose: negligible (<5%); sodium and chloride: unbound as free ions. |
| Volume of Distribution | Dextrose: ~0.2 L/kg (confined to extracellular fluid). Sodium/chloride: ~0.15 L/kg (extracellular fluid). |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: immediate. Dextrose and electrolytes distribute into plasma within seconds. |
| Duration of Action | Intravenous: ~2–8 hours depending on patient's metabolic state and hydration. Dextrose effect on blood glucose lasts ~1–2 hours; electrolyte expansion persists while infused. |
| Molecular Weight | 180.16 Da (dextrose) |
Intravenous infusion: rate determined by patient's fluid and electrolyte needs; typical maintenance dose 30-100 mL/hour for adults. 10% dextrose provides 340 kcal/L. 0.33% NaCl provides 51 mEq/L Na+.
| Dosage form | INJECTABLE |
| Renal impairment | GFR <30 mL/min: restrict volume to avoid fluid overload; monitor serum sodium and glucose. GFR 30-50: use with caution, monitor electrolytes. GFR >50: no adjustment necessary. |
| Liver impairment | Child-Pugh class B or C: no standard dose adjustment; monitor glucose and fluid status due to altered metabolism. Use with caution in severe hepatic impairment due to risk of hyperglycemia and fluid retention. |
| Pediatric use | Neonates and infants: 4-8 mg/kg/min dextrose (equivalent to 2.4-4.8 mL/kg/h of 10% dextrose); titrate to blood glucose. Children: maintenance rate based on body weight; typical 4-6 mL/kg/h for isotonic maintenance. |
| Geriatric use | Elderly: initiate at lower infusion rates (e.g., 30-50 mL/hour) due to decreased renal function; monitor for fluid overload, hyperglycemia, and electrolyte imbalances. |
| 1st trimester | Considered safe when used as a source of calories and electrolytes. No known teratogenic effects at therapeutic doses. |
| 2nd trimester | Safe for maternal hydration and electrolyte replacement; monitor for fluid/electrolyte imbalances. |
| 3rd trimester | Safe for use; avoid excessive administration to prevent maternal hyperglycemia and neonatal hypoglycemia. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Glucose and sodium cross the placenta freely; concentrations equilibrate with maternal levels. No active transport inhibition at physiologic doses. |
| Breastfeeding | Excreted into breast milk in minimal amounts; considered compatible with breastfeeding. Monitor infant for excessive glucose intake if large volumes administered. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Dextrose 10% and sodium chloride 0.33% are standard components of parenteral fluids. At therapeutic infusion rates, no teratogenic risk is anticipated; however, maternal hyperglycemia from dextrose can cause fetal hyperinsulinemia and macrosomia, especially in gestational diabetes. Hypo/hypernatremia may affect fetal fluid balance. First trimester: No known structural anomalies. Second/third trimesters: Risk of fetal hyperglycemia and fluid/electrolyte disturbances if maternal homeostasis is altered. |
| Fetal Monitoring | Monitor maternal blood glucose, serum sodium, potassium, chloride, and osmolality. Assess fluid balance: intake/output, weight, signs of edema or dehydration. Fetal monitoring: ultrasonography for growth and amniotic fluid volume if therapy prolonged. In high-risk pregnancies, monitor fetal heart rate. |
| Fertility Effects | No direct impact on fertility. Dextrose and sodium chloride support normal metabolic and fluid homeostasis; infusion at therapeutic rates does not alter reproductive function. No evidence of negative effects on ovulation, spermatogenesis, or implantation. |
■ FDA Black Box Warning
Not applicable
| Common Effects | fluid replacement |
| Serious Effects |
HyperglycemiaHypernatremiaIntracranial or intraspinal hemorrhageSevere dehydration with anuriaKnown allergy to corn or corn products
| Precautions | Use with caution in patients with heart failure, renal impairment, or conditions predisposing to hypernatremia or hyperchloremia, Monitor serum glucose and electrolyte levels regularly, Risk of hyperglycemia, especially in patients with diabetes mellitus, Avoid rapid intravenous administration to prevent osmotic diuresis and fluid overload, Not for use as a primary treatment for hypovolemia without electrolytes |
| Food/Dietary | No specific food interactions. However, patients should avoid high-sodium foods (e.g., processed snacks, canned soups) to prevent exacerbation of fluid overload or hypernatremia. |
| Clinical Pearls | This hypertonic solution (774 mOsm/L) is used for fluid resuscitation and correction of hyponatremia. Monitor serum sodium closely; rapid correction can cause osmotic demyelination syndrome. Contraindicated in patients with hypernatremia, hypervolemia, or severe renal impairment. Use with caution in heart failure and hepatic cirrhosis due to sodium load. |
| Patient Advice | Report any shortness of breath, swelling in ankles or feet, or sudden weight gain. · Inform your doctor if you have a history of high blood pressure, heart failure, or kidney disease. · Do not consume excessive salt in your diet unless advised by your physician. · You may experience increased urination as your body processes the fluids. |
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